# MORTENSON FAMILY DENTAL CENTER-CORYDON,PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386817302
- **Authorized official:** OWEN WAYNE MORTENSON (OWNER)
- **Authorized official phone:** (502) 254-8500

## Contact information

- **Practice address:** 2086 OLD HIGHWAY 135 NW, CORYDON, IN 47112-2006
- **Practice address phone:** (812) 734-1388
- **Mailing address:** PO BOX 437169, LOUISVILLE, KY 40253-7169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2008
- **Last updated:** 04/10/2008