Organization
MORTENSON FAMILY DENTAL CENTER - PROSPECT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHIE ARMSTRONG (DIRECTOR OF CREDENTIALING)
(502) 254-8501
Entity
Organization
Contact information
Practice address
9219 US HIGHWAY 42, PROSPECT, KY 40059-8857
(502) 228-2709
(502) 228-9884
Mailing address
9219 US HIGHWAY 42, PROSPECT, KY 40059-8857
(502) 228-2709
(502) 228-9884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
KY
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/11/2006
Last updated
04/14/2015
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