Individual
DR. CHARLES DAVID JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7601 LEWINSVILLE RD, SUITE 100, MC LEAN, VA 22102-2814
(703) 893-5677
(703) 893-2146
Mailing address
7601 LEWINSVILLE RD, SUITE 100, MC LEAN, VA 22102-2814
(703) 893-5677
(703) 893-2146
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401006934
VA
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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