Organization
SCOTT M JENSEN DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT M JENSEN DMD (OWNER)
(336) 379-1500
Entity
Organization
Contact information
Practice address
920 CHERRY ST, GREENSBORO, NC 27401-1422
(336) 379-1500
(336) 379-8585
Mailing address
920 CHERRY STREET, GREENSBORO, NC 27401
(336) 379-1500
(336) 379-8585
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5555
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2414647A
MEDICARE
NC
05
—
8994548
—
NC
Enumeration date
08/13/2010
Last updated
06/27/2011
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