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Individual

DAYNE R JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., D.M.D.

Contact information

Practice address
2100 NW 63RD ST, OKLAHOMA CITY, OK 73116-5111
(405) 842-6677
Mailing address
2100 NW 63RD ST, OKLAHOMA CITY, OK 73116-5111
(405) 842-6677

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6860
NE
208600000X
Surgery Physician
Primary
30823
OK

Other

Enumeration date
02/05/2010
Last updated
01/29/2015
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