Individual
DR. DAVID R. MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
355 GREENLEAF AVE, SUITE A, PARK CITY, IL 60085-5708
(847) 244-4455
Mailing address
2013 GREYSTEM CIR, APT #207, GURNEE, IL 60031-9336
(847) 244-4455
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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