Organization
PHILLIP M. JENSEN, D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP JENSEN D.M.D. (PRESIDENT)
(217) 753-8690
Entity
Organization
Contact information
Practice address
2606 MARKETPLACE DR, SPRINGFIELD, IL 62702-1467
(217) 753-8690
Mailing address
2606 MARKETPLACE DR, SPRINGFIELD, IL 62702-1467
(217) 753-8690
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019020843
IL
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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