Organization
SOUTHDALE PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES R JENSEN DDS MS (OWNER)
(952) 922-6949
Entity
Organization
Contact information
Practice address
6545 FRANCE AVE S, STE 190, EDINA, MN 55435-2184
(952) 922-6949
(952) 922-9287
Mailing address
6545 FRANCE AVE S, STE 190, EDINA, MN 55435-2184
(952) 922-6949
(952) 922-9287
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8863
MN
Other
Enumeration date
06/22/2005
Last updated
08/22/2020
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