Main Street Dental Pllc | |
123 S Main St Olivet MI 49076-9404 | |
(269) 749-9477 | |
(269) 749-9810 |
Full Name | Main Street Dental Pllc |
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Speciality | Dentist |
Location | 123 S Main St, Olivet, Michigan |
Authorized Official Name and Position | Lana Lewis (MEMBER) |
Authorized Official Contact | 2697499477 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Main Street Dental Pllc Po Box 536 Olivet MI 49076-0536 Ph: (269) 749-9477 | Main Street Dental Pllc 123 S Main St Olivet MI 49076-9404 Ph: (269) 749-9477 |
NPI Number | 1679215818 |
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Provider Enumeration Date | 04/08/2022 |
Last Update Date | 04/08/2022 |
Identifier | Type | State | Issuer |
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1679215818 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |