Mortensen, David R.

Mortensen, David R. is an individual health care provider with primary practice located at 355 Greenleaf Ave Suite A, Park City IL 60085-5708. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mortensen, David R. can be contacted via phone (847) 244-4455.

Contact Information

Primary practice address
355 Greenleaf Ave Suite A Park City IL 60085-5708
Phone: (847) 244-4455
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X Illinois

Profile Details

NPI number 1629281134
LBN Legal business name Mortensen, David R.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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