| NPI | 1912477522 |
|---|---|
| Former Legal Business Name | MARK E. JENSEN, DMD, LLC |
| Entity Type | Organization |
| Authorized Contact | MARK JENSEN Owner/Dentist 541-330-5952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2019-08-14 |