# MORTIMER FAMILY DENTISTRY, PC

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

## Provider details

- **NPI number:** 1417121732
- **Authorized official:** DR. SCOTT ALLEN MORTIMER D.D.S. (PRESIDENT)
- **Authorized official phone:** (810) 743-5131

## Contact information

- **Practice address:** 4495 S CENTER RD, BURTON, MI 48519-1417
- **Practice address phone:** (810) 743-5131
- **Practice address fax:** (810) 743-1111
- **Mailing address:** 4495 S CENTER RD, BURTON, MI 48519-1417
- **Mailing address phone:** (810) 743-5131
- **Mailing address fax:** (810) 742-1111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901014445 | MI | Yes |

## Other

- **Enumeration date:** 04/17/2008
- **Last updated:** 07/15/2015