Individual
BRANDON LEE JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2114 PIERCE ST, SIOUX CITY, IA 51104-3847
(712) 252-3440
Mailing address
2114 PIERCE ST, SIOUX CITY, IA 51104-3847
(712) 252-3440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8389
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0486480
—
IA
Enumeration date
10/26/2006
Last updated
07/08/2007
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