Individual
MATTHEW MORTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5222 DIXIE HWY, LOUISVILLE, KY 40216-1704
(502) 449-7995
(502) 449-2028
Mailing address
11708 MAIN ST, MIDDLETOWN, KY 40243-1426
(502) 245-8627
(502) 245-9395
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8234
KY
Other
Enumeration date
08/23/2006
Last updated
07/08/2007
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