| Main Dentistry, P.a. | |
|
4679 State Highway 121 Suite 109 Lewisville TX 75056-4010 | |
| (972) 370-1200 | |
| (972) 370-2679 |
| Full Name | Main Dentistry, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 4679 State Highway 121, Lewisville, Texas |
| Authorized Official Name and Position | Sujata Basawaraj (PRESIDENT) |
| Authorized Official Contact | 9723701200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Dentistry, P.a. 4679 State Highway 121 Suite 109 Lewisville TX 75056-4010 Ph: (972) 370-1200 | Main Dentistry, P.a. 4679 State Highway 121 Suite 109 Lewisville TX 75056-4010 Ph: (972) 370-1200 |
| NPI Number | 1912030230 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 09/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912030230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20290 (Texas) | Primary |
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