Individual
DR. SEAN RICHARD MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2025 W US HIGHWAY 50, A100, PUEBLO, CO 81008-1571
(719) 542-2472
Mailing address
2025 W US HIGHWAY 50, A100, PUEBLO, CO 81008-1571
(719) 542-2472
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
201996
CO
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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