| Mortenson Family Dental | |
|
5222 Dixie Hwy Louisville KY 40216-1704 | |
| (502) 449-7995 | |
| (502) 449-2028 |
| Full Name | Mortenson Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5222 Dixie Hwy, Louisville, Kentucky |
| Authorized Official Name and Position | Owen Wayne Mortenson (GEN DENTIST/OWNER) |
| Authorized Official Contact | 5022458627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mortenson Family Dental 134 N Evergreen Rd Louisville KY 40243-1487 Ph: (502) 245-7103 | Mortenson Family Dental 5222 Dixie Hwy Louisville KY 40216-1704 Ph: (502) 449-7995 |
| NPI Number | 1376655498 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376655498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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