| Main Street Dental | |
|
812 Chestnut St Bastrop TX 78602-3205 | |
| (512) 985-6607 | |
| Not Available |
| Full Name | Main Street Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 812 Chestnut St, Bastrop, Texas |
| Authorized Official Name and Position | Stacey Bartley (OWNER) |
| Authorized Official Contact | 2817445058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental 812 Chestnut St Bastrop TX 78602-3205 Ph: () - | Main Street Dental 812 Chestnut St Bastrop TX 78602-3205 Ph: (512) 985-6607 |
| NPI Number | 1710561824 |
|---|---|
| Provider Enumeration Date | 05/06/2021 |
| Last Update Date | 05/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710561824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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