Individual
DR. DAMON TY JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
U.S. NAVAL HOSPITAL GUAM, FARENHOLT AVE, BLDG 50, AGANA HEIGHTS, GU 96910-0140
(671) 483-2239
Mailing address
PSC 455 BOX 208, FPO, AP 96540-0003
(671) 483-2239
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
NOT ISSUED TO DATE
WY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1181
WY
Other
Enumeration date
06/28/2007
Last updated
09/15/2023
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