Organization
MORTENSON FAMILY DENTAL CENTER - ELIZABETHTOWN NORTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE JAMES (CFO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
2110 N DIXIE HWY, ELIZABETHTOWN, KY 42701-8811
(270) 982-4433
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
(502) 254-8500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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