Stewart Wayne Jensen, D.D.S.

NPI #1104086677 in Logan, Utah

Provider Information

NPI Number: 1104086677
Entity Type: Individual
Name: Stewart Wayne Jensen, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Jun 9, 2008
Last Updated: Jun 9, 2008

Practice Location

Address: 167 E 200 N
Address 2: STE 1
City: Logan
State: Utah
ZIP Code: 84321-4049
Phone: (435) 752-5451

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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