| 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 |