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Individual

LYNN D. MORTENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4509 S 6TH ST, SUITE 302, KLAMATH FALLS, OR 97603-4880
(541) 883-2630
(541) 883-2630
Mailing address
4509 S 6TH ST, SUITE 302, KLAMATH FALLS, OR 97603-4880
(541) 883-2630
(541) 883-2630

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5883
OR

Other

Enumeration date
04/03/2007
Last updated
07/08/2007
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