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Organization

STEPHEN RAY JENSEN DDS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHEN JENSEN DDS (ORTHODONTIST/OWNER)
(575) 522-1779
Entity
Organization

Contact information

Practice address
1161 MALL DR STE A, LAS CRUCES, NM 88011-8193
(575) 522-1779
(575) 522-4789
Mailing address
1161 MALL DR STE A, LAS CRUCES, NM 88011-8193
(575) 522-1779
(575) 522-4789

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DD3479
NM

Other

Enumeration date
09/15/2011
Last updated
09/15/2011
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