Organization
SJ ORAL SURGERY PC
Active
Other names
South Jordan Oral and Facial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DAYNE JENSEN MD, DMD (PRESIDENT)
(801) 698-7121
Entity
Organization
Contact information
Practice address
3632 W SOUTH JORDAN PKWY STE 103, SOUTH JORDAN, UT 84009-7163
(580) 355-6000
Mailing address
3632 W SOUTH JORDAN PKWY STE 103, SOUTH JORDAN, UT 84009-7163
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
183
OK
Other
Enumeration date
03/27/2018
Last updated
03/27/2018
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