Organization
TIMPANOGAS PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT A JENSEN (SURGEON)
(801) 492-1346
Entity
Organization
Contact information
Practice address
25 NORTH 1100 EAST, AMERICAN FORK, UT 84003
(801) 492-1346
(801) 492-1320
Mailing address
25 NORTH 1100 EAST, AMERICAN FORK, UT 84003
(801) 492-1346
(801) 492-1320
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3085413-9923
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
518047570014
—
UT
Enumeration date
01/26/2007
Last updated
07/15/2008
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