Organization
PLAIN CITY FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER CHRISTIAN MORTENSON DDS (SOLE MEMBER)
(801) 948-0673
Entity
Organization
Contact information
Practice address
2384 N 4350 W, PLAIN CITY, UT 84404-9617
(801) 948-0673
Mailing address
3968 W 5700 S, ROY, UT 84067-9176
(801) 376-6494
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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