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Individual

J MARK JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
327 DEINHARD LN, MCCALL, ID 83638-4703
(208) 634-3370
Mailing address
327 DEINHARD LN, MCCALL, ID 83638-4703
(208) 634-3370

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-1780
ID

Other

Enumeration date
10/12/2006
Last updated
07/08/2007
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