Organization
MFDC OF KY LLC
Active
Parent organization
MORTENSON FAMILY DENTAL CENTER
Other names
Mortenson Family Dental Center - Dry RIdge
Organization subpart
Yes
Provider details
NPI number
Legal business name
MORTENSON FAMILY DENTAL CENTER
Authorized official
JEFF REIBEL (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
99 S MAIN ST, DRY RIDGE, KY 41035-7343
(859) 785-5717
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/17/2021
Last updated
05/28/2021
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