| Mortenson Family Dental | |
|
2005 S Highway 53 Lagrange KY 40031-9109 | |
| (502) 225-0074 | |
| (502) 225-0882 |
| Full Name | Mortenson Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2005 S Highway 53, Lagrange, Kentucky |
| Authorized Official Name and Position | Owen Wayne Mortenson (GEN DENTIST/OWNER) |
| Authorized Official Contact | 5022458627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mortenson Family Dental 134 N Evergreen Rd Suite 102 Middletown KY 40243-1487 Ph: (502) 245-7103 | Mortenson Family Dental 2005 S Highway 53 Lagrange KY 40031-9109 Ph: (502) 225-0074 |
| NPI Number | 1730291493 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730291493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Engileman Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2005 S Highway 53, Lagrange, KY 40031 Phone: 502-222-4613 Fax: 502-225-0882 |