| Main Street Family Dental Care P.a. | |
|
411 Main St Suite 308 Saint Paul MN 55102-1080 | |
| (651) 227-6561 | |
| (651) 297-6852 |
| Full Name | Main Street Family Dental Care P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 411 Main St, Saint Paul, Minnesota |
| Authorized Official Name and Position | Jayne F. Grout (OFFICE MANAGER) |
| Authorized Official Contact | 6512276561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Family Dental Care P.a. 411 Main St Suite 308 Saint Paul MN 55102-1080 Ph: (651) 227-6561 | Main Street Family Dental Care P.a. 411 Main St Suite 308 Saint Paul MN 55102-1080 Ph: (651) 227-6561 |
| NPI Number | 1033170857 |
|---|---|
| Provider Enumeration Date | 03/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033170857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9068 (Minnesota) | Primary |
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