| Main Street Dental Of Kenyon Pa | |
|
216 Forest St Kenyon MN 55946 | |
| (507) 789-6815 | |
| Not Available |
| Full Name | Main Street Dental Of Kenyon Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 216 Forest St, Kenyon, Minnesota |
| Authorized Official Name and Position | Duy Vu (DENTIST) |
| Authorized Official Contact | 6512356604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental Of Kenyon Pa 216 Forest St Kenyon MN 55946-1151 Ph: (507) 789-6815 | Main Street Dental Of Kenyon Pa 216 Forest St Kenyon MN 55946 Ph: (507) 789-6815 |
| NPI Number | 1700136116 |
|---|---|
| Provider Enumeration Date | 09/12/2012 |
| Last Update Date | 06/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700136116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D12683 (Minnesota) | Primary |
William L Lewis D.d.s.,p.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 Forest St, Kenyon, MN 55946 Phone: 507-789-6211 Fax: 507-789-6210 |