Individual
DR. JARED MICHAEL SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6750 N 19TH AVE, PHOENIX, AZ 85015-1127
(602) 242-5741
(602) 242-5742
Mailing address
6750 N 19TH AVE, PHOENIX, AZ 85015-1127
(602) 242-5741
(602) 242-5742
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D008158
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/04/2009
Last updated
11/17/2020
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