Organization
MORTENSON FAMILY DENTAL CENTER - VERSAILLES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE JAMES (CFO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
217 N MAIN ST, VERSAILLES, KY 40383-1266
(859) 873-0565
Mailing address
134 EVERGREEN RD, SUITE 200, LOUISVILLE, KY 40243-1487
(502) 254-8501
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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