Organization
MORTENSON FAMILY DENTAL CENTER
Active
Other names
engilman orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE JAMES (CFO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
10640 DIXIE HWY, LOUISVILLE, KY 40272-4350
(502) 933-4455
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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