Individual
DYLAN JACOB JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3626 W 5600 S, ROY, UT 84067-9161
(801) 985-2273
Mailing address
488 W 150 N, OREM, UT 84057-1961
(801) 319-1772
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11775286-9922
UT
Other
Enumeration date
05/20/2020
Last updated
05/20/2020
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