MEDICARE: ALLISON JENSEN, DMD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1558833459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLISON JENSEN, DMD, PC

Provider Business Mailing Address
First Line	:	112 N 4TH ST
Second Line	:
City	:	GENEVA
State	:	IL
Zip	:	60134-2125
Country	:	US
Telephone Number	:	630-232-4076
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 N 4TH ST
Second Line	:
City	:	GENEVA
State	:	IL
Zip	:	60134-2125
Country	:	US
Telephone Number	:	630-232-4076
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALLISON WOLSKI
Credential	:
Telephone Number	:	630-232-4076

Provider Enumeration Date	:	12/18/2018
Last Update Date	:	12/18/2018

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