| NPI | 1962065565 |
|---|---|
| Doing Business As | MORTENSON FAMILY DENTAL - SCOTTSBURG |
| Entity Type | Organization |
| Authorized Contact | JEFF REIBEL CFO 502-254-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2023-09-06 |