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Individual

DR. BRIAN STEVEN MORTENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
36014 WRATTEN AVE., FORT HOOD, TX 76544
(254) 286-7401
Mailing address
6895 S CAPTIVA CV, COTTONWOOD HEIGHTS, UT 84121-3473
(928) 830-2763

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
32124
TX
1223P0221X
Pediatric Dentistry
Primary
11672604-9922
UT

Other

Enumeration date
09/01/2016
Last updated
05/07/2020
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