Organization
MORTENSON FAMILY DENTAL CENTER - MAINEVILLE LLC
Active
Other names
Kids Dentistree - Maineville
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF REIBEL (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
6028 SOUTH STATE ROAD 48, MAINEVILLE, OH 45039
(513) 334-4099
(513) 453-7179
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
(513) 334-4099
(513) 453-7179
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/24/2017
Last updated
12/15/2022
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