Mortenson Family Dental

NPI #1730291493 in Lagrange, Kentucky

Provider Information

NPI Number
1730291493
Entity Type
Organization
Organization Name
Mortenson Family Dental
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Aug 31, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
2005 S HIGHWAY 53
ZIP Code
40031-9109
Phone
(502) 225-0074

Authorized Official

Name
DR. OWEN WAYNE MORTENSON, DMD
Title
GEN DENTIST/OWNER
Phone
(502) 245-8627

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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