| Mortenson Family Dental Center - Simpsonville, Pllc | |
|
137 Buck Creek Rd Simpsonville KY 40067-6674 | |
| (502) 722-2110 | |
| (502) 722-2116 |
| Full Name | Mortenson Family Dental Center - Simpsonville, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 137 Buck Creek Rd, Simpsonville, Kentucky |
| Authorized Official Name and Position | Ronel Mccombs (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5022548500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mortenson Family Dental Center - Simpsonville, Pllc Po Box 437169 Louisville KY 40253-7169 Ph: (502) 254-8500 | Mortenson Family Dental Center - Simpsonville, Pllc 137 Buck Creek Rd Simpsonville KY 40067-6674 Ph: (502) 722-2110 |
| NPI Number | 1285978288 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 11/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285978288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |