Individual
DR. ALLEN WAYNE MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4495 S CENTER RD, BURTON, MI 48519-1417
(810) 743-5131
(810) 743-1111
Mailing address
4495 S CENTER RD, BURTON, MI 48519-1417
(810) 743-5131
(810) 743-1111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901020727
MI
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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