| Main Street Dental | |
|
99 S Main St Memphis TN 38103-2910 | |
| (901) 527-0716 | |
| (901) 527-0718 |
| Full Name | Main Street Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 99 S Main St, Memphis, Tennessee |
| Authorized Official Name and Position | Jodi E Rump (OWNER) |
| Authorized Official Contact | 9015270716 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental 99 S Main St Memphis TN 38103-2910 Ph: (901) 527-0716 | Main Street Dental 99 S Main St Memphis TN 38103-2910 Ph: (901) 527-0716 |
| NPI Number | 1326434085 |
|---|---|
| Provider Enumeration Date | 04/09/2015 |
| Last Update Date | 04/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326434085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DS0000007994 (Tennessee) | Primary |
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