| Main Street Dental, Pc | |
|
6240 S Main St Suite 295 Aurora CO 80016-5376 | |
| (303) 627-5460 | |
| (303) 627-5438 |
| Full Name | Main Street Dental, Pc |
|---|---|
| Speciality | Dentist |
| Location | 6240 S Main St, Aurora, Colorado |
| Authorized Official Name and Position | Brian W Langenfeld (DENTIST) |
| Authorized Official Contact | 3036275460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental, Pc 6240 S Main St Suite 295 Aurora CO 80016-5376 Ph: (303) 627-5460 | Main Street Dental, Pc 6240 S Main St Suite 295 Aurora CO 80016-5376 Ph: (303) 627-5460 |
| NPI Number | 1659817328 |
|---|---|
| Provider Enumeration Date | 01/18/2017 |
| Last Update Date | 01/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659817328 | NPI | - | NPPES |
| 93222858 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 104888 (Colorado) | Primary |
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