Individual
DR. ROBERT MANNING MORTENSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
2925 DEBARR RD, ALASKA VA HEALTH CARE SYSTEM/REGIONAL OFFICE, (160), ANCHORAGE, AK 99508
(907) 257-4940
(907) 257-4953
Mailing address
19633 BIG DIOMEDE CIR, EAGLE RIVER, AK 99577-8797
(907) 696-8776
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13666
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13666
DENTAL LISENCE
MO
01
—
5510
DENTAL LISENCE
KS
01
—
5614
DENTAL LISENCE
NE
Enumeration date
04/26/2006
Last updated
07/08/2007
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