Individual
DR. AMANDA JORGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
100 SW BROOKSIDE DR, GRIMES, IA 50111
(515) 986-3926
(515) 986-5116
Mailing address
1410 SE ROSEWOOD CT, WAUKEE, IA 50263-8350
(515) 778-4278
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08223
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0293605
—
IA
Enumeration date
07/19/2006
Last updated
04/26/2013
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