| Main Street Dental | |
|
810 N Main Ave Gresham OR 97030-5538 | |
| (503) 665-8283 | |
| (503) 669-7263 |
| Full Name | Main Street Dental |
|---|---|
| Speciality | Dentist |
| Location | 810 N Main Ave, Gresham, Oregon |
| Authorized Official Name and Position | Kate Harmston (OFFICE MANAGER) |
| Authorized Official Contact | 5036658283 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental 810 N Main Ave Gresham OR 97030-5538 Ph: (503) 665-8283 | Main Street Dental 810 N Main Ave Gresham OR 97030-5538 Ph: (503) 665-8283 |
| NPI Number | 1124571369 |
|---|---|
| Provider Enumeration Date | 07/23/2016 |
| Last Update Date | 07/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124571369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D10345 (Oregon) | Primary |
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