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1891857579
MICAH G. MORTENSEN
SALT LAKE CITY, UT
NPI
1891857579
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: UT 4726746-9921)
Enumeration Date
2006-12-15
Last Update Date
2022-06-15
Business Address
Dr. MICAH G. MORTENSEN D.D.S., M.S.D.
6287 S REDWOOD RD STE 202
SALT LAKE CITY, UT 84123-6655
Phone number: 801-262-3777
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Mailing Address
Dr. MICAH G. MORTENSEN D.D.S., M.S.D.
15359 W COLUMBINE DR
SURPRISE, AZ 85379-9190
Phone number:
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