Individual
DR. JACK DENZIL JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7107 NE VANCOUVER MALL DR, SUITE #D, VANCOUVER, WA 98661-8178
(360) 892-6555
(360) 892-4170
Mailing address
7107 NE VANCOUVER MALL DR, STE D, VANCOUVER, WA 98661-8179
(360) 892-6555
(360) 892-4170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00009473
WA
Other
Enumeration date
09/04/2006
Last updated
07/01/2016
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