Celeste C Mortenson Pc | |
169 N Gateway Dr Ste 175 Providence UT 84332-9825 | |
(435) 752-0605 | |
(435) 755-8574 |
Full Name | Celeste C Mortenson Pc |
---|---|
Speciality | Dentist - General Practice |
Location | 169 N Gateway Dr Ste 175, Providence, Utah |
Authorized Official Name and Position | Celeste C Mortenson (OWNER, PRESIDENT) |
Authorized Official Contact | 4355120133 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Celeste C Mortenson Pc 361 Edgehill Dr Providence UT 84332-9426 Ph: (435) 512-0133 | Celeste C Mortenson Pc 169 N Gateway Dr Ste 175 Providence UT 84332-9825 Ph: (435) 752-0605 |
NPI Number | 1376035196 |
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Provider Enumeration Date | 06/06/2018 |
Last Update Date | 06/06/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376035196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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