| Main Street Dental, Pllc | |
|
409 E Main St Locust Grove OK 74352-5116 | |
| (918) 845-5505 | |
| Not Available |
| Full Name | Main Street Dental, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 409 E Main St, Locust Grove, Oklahoma |
| Authorized Official Name and Position | David Henry (OWNER) |
| Authorized Official Contact | 9184798020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental, Pllc 1707 Forest Hill Dr Claremore OK 74017 Ph: (918) 845-5505 | Main Street Dental, Pllc 409 E Main St Locust Grove OK 74352-5116 Ph: (918) 845-5505 |
| NPI Number | 1679072664 |
|---|---|
| Provider Enumeration Date | 02/06/2018 |
| Last Update Date | 03/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679072664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 6531 (Oklahoma) | Primary |
Dental Arts Of Locust Grove, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 409 E Main St, Locust Grove, OK 74352 Phone: 918-888-5055 | |
Absolute Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 409 E. Main Street, Locust Grove, OK 74352 Phone: 918-479-8020 |