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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BRENT W MORTENSON, DMD

Active

BRENT W MORTENSON, DMD is a Oral & Maxillofacial Surgery healthcare provider located in LOUISVILLE, Kentucky. NPI 1356369169 is currently active in the NPPES registry. Verify at CMS.

Oral & Maxillofacial Surgery · LOUISVILLE, KY

Registration Details

NPI Number
1356369169
Provider Type
Individual
Gender
Male
NPI Issued
Jul 18, 2006 (20.114924875099 yrs)
Last Updated
Jun 18, 2014
Licenses
7229 (KY)
7229 (KY)
7229 (KY)
7229 (KY)

Practice Information

Address
134 EVERGREEN RD
SUITE 103
LOUISVILLE, KY, 402431487
Browse KY providers · Browse ZIP 40243
Phone
5024101702
Fax
5022440817
Primary Specialty
Oral & Maxillofacial Surgery
1223S0112X
Additional Specialty
Pediatric Dentistry
Additional Specialty
Oral & Maxillofacial Surgery

Other Oral & Maxillofacial Surgery Providers in LOUISVILLE, KY

Name Credential NPI
RICHARD A PAPE DMD MS 1053312066
WILLIAM M EPSTEIN DMD 1336140862
THEODORE E LOGAN JR. DMD 1245231778
JULIE M HARRIS DMD 1154322683
DR. NATHAN FREDERICK WALTERS DMD 1265424907
DR. CHRISTOPHER C BABCOCK DMD MD 1487646139
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.