Provider Demographics
NPI:1558582908
Name:JENSEN, CURTIS DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:DEAN
Last Name:JENSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 POMME DE TERRE
Mailing Address - Street 2:P.O. BOX 737
Mailing Address - City:MARSHFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65706-2386
Mailing Address - Country:US
Mailing Address - Phone:417-468-2972
Mailing Address - Fax:417-468-4202
Practice Address - Street 1:497 POMME DE TERRE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MO
Practice Address - Zip Code:65706-2386
Practice Address - Country:US
Practice Address - Phone:417-468-2972
Practice Address - Fax:417-468-4202
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0145811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice