| Ennis Hometown Dental | |
|
400 W Ennis Ave Ennis TX 75119-3904 | |
| (972) 875-9031 | |
| (972) 878-9031 |
| Full Name | Ennis Hometown Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 400 W Ennis Ave, Ennis, Texas |
| Authorized Official Name and Position | Jorden Mark Mortensen (OWNER) |
| Authorized Official Contact | 5125206365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ennis Hometown Dental 400 W Ennis Ave Ennis TX 75119-3904 Ph: (972) 875-9031 | Ennis Hometown Dental 400 W Ennis Ave Ennis TX 75119-3904 Ph: (972) 875-9031 |
| NPI Number | 1700684701 |
|---|---|
| Provider Enumeration Date | 03/05/2025 |
| Last Update Date | 03/05/2025 |
| Certification Date | 03/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700684701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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