BRENT MORTENSON, DMD

Dentist - Oral and Maxillofacial Surgery

Active Individual
NPI: 1356369169

Practice Address

134 EVERGREEN RD
SUITE 103
Louisville, KY 40243

Phone: (502) 410-1702

Specialties

Specialty Code Primary License
Dentist 122300000X No 7229 (KY)
Dentist - Pediatric Dentistry 1223P0221X No 7229 (KY)
Dentist - Oral and Maxillofacial Surgery 1223S0112X Yes 7229 (KY)
Oral & Maxillofacial Surgery 204E00000X No 7229 (KY)

Frequently Asked Questions

NPI 1356369169 is the National Provider Identifier for BRENT MORTENSON, DMD, a Dentist - Oral and Maxillofacial Surgery provider located in Louisville, KY. This NPI was enumerated on July 18, 2006.
BRENT MORTENSON, DMD practices at 134 EVERGREEN RD, SUITE 103, Louisville, KY 40243.

Quick Facts

NPI
1356369169
Type
Individual
Enumerated
Jul 18, 2006
Last Updated
Jun 18, 2014

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