Individual
DR. JAKE DANIEL SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
40 W. CACHE VALLEY BLVD. #2A, LOGAN, UT 84341
(435) 787-8207
Mailing address
169 SOUTH 380 EAST, SMITHFIELD, UT 84335
(435) 213-6991
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8021465-8903
UT
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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