Individual
DR. BRADLEY S MORTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2074 S 6TH ST, KLAMATH FALLS, OR 97601-3372
(541) 880-2028
Mailing address
2074 S 6TH ST, KLAMATH FALLS, OR 97601-3372
(541) 880-2028
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9795
OR
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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