Mortenson Family Dental Center-Elizabethtown,PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MORTENSON FAMILY DENTAL CENTER-ELIZABETHTOWN,PLLC

Practice address

2407 Ring Rd
Suite 137
Elizabethtown, KY 42701-5937

Phone

(270) 360-0480

Fax

(270) 360-0490

NPI assigned

Jul 28, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steve C James

Title

Coo

Phone

(502) 254-8504

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1033374228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 RING RD",
            "address_2": "SUITE 137",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427015937",
            "telephone_number": "270-360-0480",
            "fax_number": "270-360-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER-ELIZABETHTOWN,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "502-254-8504"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malik Dante Morris
• Traci Gail Morris, APRN
• Beth Etta Morrow, PA-C
• Richard Keenan Morse, LAT, ATC, EMT
• Mortenson Family Dental Center - Elizabethtown North, PLLC
• Kaitlin Marie Moutardier
• Sandra Carol Moyer
• Liene Muceniece, MD
• Bethany Mudd
• Carlee Mudd, APRN

• Dental Clinic/Center in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.