| Mortenson Family Dental Center-corydon,pllc | |
|
2086 Old Highway 135 Nw Corydon IN 47112-2006 | |
| (812) 734-1388 | |
| Not Available |
| Full Name | Mortenson Family Dental Center-corydon,pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2086 Old Highway 135 Nw, Corydon, Indiana |
| Authorized Official Name and Position | Owen Wayne Mortenson (OWNER) |
| Authorized Official Contact | 5022548500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mortenson Family Dental Center-corydon,pllc Po Box 437169 Louisville KY 40253-7169 Ph: () - | Mortenson Family Dental Center-corydon,pllc 2086 Old Highway 135 Nw Corydon IN 47112-2006 Ph: (812) 734-1388 |
| NPI Number | 1386817302 |
|---|---|
| Provider Enumeration Date | 04/10/2008 |
| Last Update Date | 04/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386817302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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