Organization
ENNIS HOMETOWN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDEN MARK MORTENSEN DMD (OWNER)
(512) 520-6365
Entity
Organization
Contact information
Practice address
400 W ENNIS AVE, ENNIS, TX 75119-3904
(972) 875-9031
(972) 878-9031
Mailing address
400 W ENNIS AVE, ENNIS, TX 75119-3904
(972) 875-9031
(972) 878-9031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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