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Organization
PLAIN CITY FAMILY DENTAL PLLC
Active
Organization
PLAIN CITY FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER CHRISTIAN MORTENSON DDS (SOLE MEMBER)
(801) 948-0673
Entity
Organization
Contact information
Practice address
2384 N 4350 W, PLAIN CITY, UT 84404-9617
(801) 948-0673
Mailing address
3968 W 5700 S, ROY, UT 84067-9176
(801) 376-6494
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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