| Main Street Dental | |
|
108 S Main St Buda TX 78610-3375 | |
| (512) 295-9925 | |
| Not Available |
| Full Name | Main Street Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 108 S Main St, Buda, Texas |
| Authorized Official Name and Position | Justin Dexter Koen (PARTNER) |
| Authorized Official Contact | 5122959925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental 108 S Main St Buda TX 78610-3375 Ph: (512) 295-9925 | Main Street Dental 108 S Main St Buda TX 78610-3375 Ph: (512) 295-9925 |
| NPI Number | 1770193070 |
|---|---|
| Provider Enumeration Date | 08/03/2020 |
| Last Update Date | 08/03/2020 |
| Certification Date | 08/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770193070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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