| Main Street Dental Group | |
|
131 W Ontario Ave Ste. 102 Corona CA 92882-5274 | |
| (951) 898-9700 | |
| (951) 898-9779 |
| Full Name | Main Street Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 131 W Ontario Ave, Corona, California |
| Authorized Official Name and Position | Charles F Rodgers (OWNER DDS) |
| Authorized Official Contact | 9518989700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental Group 2860 Michelle 2nd Floor Irvine CA 92606-1009 Ph: (714) 508-3600 | Main Street Dental Group 131 W Ontario Ave Ste. 102 Corona CA 92882-5274 Ph: (951) 898-9700 |
| NPI Number | 1154413912 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 06/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154413912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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