Jensen, Peder J

Jensen, Peder J is an individual health care provider with primary practice located at 2501 Crestwood Rd Ste 102 , North Little Rock AR 72116-7615. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Jensen, Peder J can be contacted via phone (501) 758-6182.

Contact Information

Primary practice address
2501 Crestwood Rd Ste 102 North Little Rock AR 72116-7615
Phone: (501) 758-6182
Fax: (501) 758-6184
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 2544 Arkansas

Profile Details

NPI number 1407907165
LBN Legal business name Jensen, Peder J
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407907165 NPPES
Arkansas Other 2544 ARKANSAS DENTAL LICENSE

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