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General NPI Number Information
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NPI Number | 1689749343
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Entity Type | Individual
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Provider Name | JENS F JORGENSEN DMD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 7 E MAITLAND LANE
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City | NEW CASTLE
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State | PA
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Zip | 16105-1203
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Country | US
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Telephone | 724-658-2304
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Fax | 724-658-5911
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Provider Business Mailing Address
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Address Line | 7 E MAITLAND LN
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City | NEW CASTLE
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State | PA
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Zip | 16105-1203
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Country | US
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Telephone | 724-658-2304
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Fax | 724-658-5911
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS017425L
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License Number State | PA
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