MORTENSON FAMILY DENTAL NPI 1760593602

NPI Information

NPI: 1760593602
Provider Name: MORTENSON FAMILY DENTAL
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
11708 MAIN ST
MIDDLETOWN, KY
ZIP 40243
Phone: (502) 245-8627
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MORTENSON FAMILY DENTAL is a dental clinic center in Middletown, KY. MORTENSON FAMILY DENTAL NPI is 1760593602. The provider is registered as an organization entity type.

The provider's business location address is:

11708 MAIN ST
MIDDLETOWN, KY
ZIP 40243-426
Phone: (502) 245-8627
Fax: (502) 245-9395

The provider's authorized official is Owen Wayne Mortenson .
The authorized official title is Owner/general Dentist and has the following contact phone number (502) 245-8627.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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