Individual
DR. DARREL JOE JENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1814 COBURG RD, BLDG 2, EUGENE, OR 97401-4986
(541) 342-3398
(541) 342-1620
Mailing address
1814 COBURG RD, BLDG 2, EUGENE, OR 97401-4986
(541) 342-3398
(541) 342-1620
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5826
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22853-6
OMAP POVIDER NUMBER
OR
01
—
829878
UNITED CONCORDIA POVIDER
OR
Enumeration date
01/03/2007
Last updated
07/08/2007
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