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Organization
MORTENSON FAMILY DENTAL CENTER - JEFFERSONTOWN CENTRAL, PLLC
Active
Organization
MORTENSON FAMILY DENTAL CENTER - JEFFERSONTOWN CENTRAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JAMES (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
10004 TAYLORSVILLE RD, LOUISVILLE, KY 40299-3134
(502) 267-7736
Mailing address
10004 TAYLORSVILLE RD, LOUISVILLE, KY 40299-3134
(502) 267-7736
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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