| Main Street Dental Group | |
|
4360-c E Main St Ventura CA 93003 | |
| (805) 644-6110 | |
| (805) 644-6160 |
| Full Name | Main Street Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4360-c E Main St, Ventura, California |
| Authorized Official Name and Position | Maral Khazali (OWNER DDS) |
| Authorized Official Contact | 8056446110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental Group Po Box 920050 Dallas TX 75392-0050 Ph: (714) 508-3600 | Main Street Dental Group 4360-c E Main St Ventura CA 93003 Ph: (805) 644-6110 |
| NPI Number | 1073698429 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073698429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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