# MFDC OF INDIANA, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mortenson Family Dental - Scottsburg
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962065565
- **Authorized official:** JEFF REIBEL (CFO)
- **Authorized official phone:** (502) 254-8500

## Contact information

- **Practice address:** 1606 W MCCLAIN AVE, SCOTTSBURG, IN 47170
- **Practice address phone:** (502) 254-8500
- **Mailing address:** PO BOX 437169, LOUISVILLE, KY 40253-7169

## Taxonomy

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

## Other

- **Enumeration date:** 04/18/2019
- **Last updated:** 09/06/2023