Mortenson Family Dental

Organization Active NPI Dental Clinic/Center · Middletown, KY

NPI 1760593602 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1760593602
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
Legal business name
MORTENSON FAMILY DENTAL
Practice address
11708 Main St
Middletown, KY 40243-1426
Phone
(502) 245-8627
Fax
(502) 245-9395
NPI assigned
Aug 31, 2006
Organization subpart
No

Authorized official

Name
Dr. Owen Wayne Mortenson, DMD
Title
Owner/General Dentist
Phone
(502) 245-8627

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Yes

Addresses

Primary practice location

11708 Main St
Middletown, KY 40243-1426

Mailing address

11708 Main St
Middletown, KY 40243-1426
Phone (502) 245-8627

Other providers in Middletown, KY

All providers in Middletown, KY · Dental Clinic/Center in Kentucky

Sources for this page

Verify at the official NPI Registry.