DR. Sean Richard Mortensen, D.D.S.

NPI #1104266949 in Pueblo, Colorado

Provider Information

NPI Number: 1104266949
Entity Type: Individual
Name: DR. Sean Richard Mortensen, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Jun 25, 2013
Last Updated: Jun 25, 2013

Practice Location

Address: 2025 W US HIGHWAY 50
Address 2: A100
City: Pueblo
State: Colorado
ZIP Code: 81008-1571
Phone: (719) 542-2472

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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