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General NPI Number Information
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NPI Number | 1881096279
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Entity Type | Organization
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Legal Business Name | TERRY M. JENSEN
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 322 M ST
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City | NELIGH
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State | NE
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Zip | 68756-1421
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Country | US
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Telephone | 402-887-5214
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Fax | 402-887-4904
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Provider Business Mailing Address
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Address Line | 322 M ST PO BOX 206
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City | NELIGH
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State | NE
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Zip | 68756-1421
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Country | US
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Telephone | 402-887-5214
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Fax | 402-887-4904
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Authorized Official
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Title or Position | DENTIST
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Name | DR. TERRY M JENSEN
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Credential | DDS
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Telephone | 402-887-5214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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