| NPI | 1851598437 |
|---|---|
| Professional Name | DAMON TY JENSEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WY 1181) |
| Additional Taxonomies | 122300000X Dentist (Licence: WY NOT ISSUED TO DATE) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2023-09-15 |