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Organization
RED OAK HOMETOWN DENTAL
Active
Organization
RED OAK HOMETOWN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDEN MARK MORTENSEN DMD (OWNER)
(512) 520-6365
Entity
Organization
Contact information
Practice address
101 AUSTIN BLVD STE 100, RED OAK, TX 75154-4661
(972) 617-3508
Mailing address
101 AUSTIN BLVD STE 100, RED OAK, TX 75154-4661
(972) 617-3508
(972) 576-5202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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