Organization
MORTENSON FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OWEN WAYNE MORTENSON (GEN DENTIST/OWNER)
(502) 245-8627
Entity
Organization
Contact information
Practice address
5222 DIXIE HWY, LOUISVILLE, KY 40216-1704
(502) 449-7995
(502) 449-2028
Mailing address
134 N EVERGREEN RD, LOUISVILLE, KY 40243-1487
(502) 245-7103
(502) 253-2202
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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