| Jason Sorensen D.d.s. A Professional Corporation | |
|
1480 W Herndon Ave Fresno CA 93711-0552 | |
| (559) 447-0544 | |
| (559) 431-1827 |
| Full Name | Jason Sorensen D.d.s. A Professional Corporation |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1480 W Herndon Ave, Fresno, California |
| Authorized Official Name and Position | Jason Sorensen (PRESIDENT) |
| Authorized Official Contact | 5594470544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Sorensen D.d.s. A Professional Corporation 1480 W Herndon Ave Fresno CA 93711-0552 Ph: (559) 447-0544 | Jason Sorensen D.d.s. A Professional Corporation 1480 W Herndon Ave Fresno CA 93711-0552 Ph: (559) 447-0544 |
| NPI Number | 1952528671 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 12/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952528671 | NPI | - | NPPES |
| G9286601 | Other | CA | DENTI-CAL PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 46690 (California) | Primary |
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