| NPI | 1437742855 |
|---|---|
| Doing Business As | MORTENSON FAMILY DENTAL CENTER - DRY RIDGE |
| Entity Type | Organization |
| Authorized Contact | JEFF REIBEL CFO 502-254-8500 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2021-05-28 |