# MFDC OF KY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MORTENSON FAMILY DENTAL CENTER
- **Other names:** Mortenson Family Dental Center - Dry RIdge
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437742855
- **Legal business name:** MORTENSON FAMILY DENTAL CENTER
- **Authorized official:** JEFF REIBEL (CFO)
- **Authorized official phone:** (502) 254-8500

## Contact information

- **Practice address:** 99 S MAIN ST, DRY RIDGE, KY 41035-7343
- **Practice address phone:** (859) 785-5717
- **Mailing address:** PO BOX 437169, LOUISVILLE, KY 40253-7169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2021
- **Last updated:** 05/28/2021