Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 032583 | NY |
NPI | 1093809014 |
---|---|
Provider Name | Dr. Steven Alan Jenson |
First Address | Buffalo, NY 14223 |
Second Address | Buffalo, NY 14223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |