NPI 1386733459

J Mark Jensen, DMD

Practitioner Dentist McCall, ID

Practice location

Address: 327 Deinhard Ln, McCall, ID 83638-4703
Phone: (208) 634-3370

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D-1780 (ID)

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Registry record

NPI: 1386733459
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Oct 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.