Organization
MORTENSON FAMILY DENTAL CENTER-CORYDON,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN WAYNE MORTENSON (OWNER)
(502) 254-8500
Entity
Organization
Contact information
Practice address
2086 OLD HIGHWAY 135 NW, CORYDON, IN 47112-2006
(812) 734-1388
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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