Individual
DR. DAVID GLEN MORTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.D.
Contact information
Practice address
2208 S BARRINGTON, MESA, AZ 85209-5328
(480) 450-0829
Mailing address
3303 S LINDSAY RD, SUITE 127, GILBERT, AZ 85297-1503
(480) 450-0829
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
8016
AZ
1223E0200X
Endodontics
8995
KY
Other
Enumeration date
08/18/2010
Last updated
02/04/2016
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