Individual
DOUGLAS JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1332 LINDEN ST, SUITE 2, LONGMONT, CO 80501-3257
(303) 772-2392
Mailing address
1332 LINDEN ST, SUITE 2, LONGMONT, CO 80501-3257
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
HD1-00959
CO
Other
Enumeration date
01/21/2008
Last updated
01/21/2008
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