| Mortenson Family Dental Center - Shelbyville Pllc | |
|
130 Stonecrest Rd Suite 101 Shelbyville KY 40065-8126 | |
| (502) 633-1584 | |
| (502) 633-1509 |
| Full Name | Mortenson Family Dental Center - Shelbyville Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 130 Stonecrest Rd, Shelbyville, Kentucky |
| Authorized Official Name and Position | Stephen James (CFO) |
| Authorized Official Contact | 5022548504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mortenson Family Dental Center - Shelbyville Pllc Po Box 437169 Louisville KY 40253-7169 Ph: (502) 254-8501 | Mortenson Family Dental Center - Shelbyville Pllc 130 Stonecrest Rd Suite 101 Shelbyville KY 40065-8126 Ph: (502) 633-1584 |
| NPI Number | 1952312118 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 08/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952312118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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