| Main Street Dental Pllc | |
|
123 S Main St Olivet MI 49076-9404 | |
| (269) 749-9477 | |
| (269) 749-9810 |
| Full Name | Main Street Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 123 S Main St, Olivet, Michigan |
| Authorized Official Name and Position | Lana Lewis (MEMBER) |
| Authorized Official Contact | 2697499477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Dental Pllc Po Box 536 Olivet MI 49076-0536 Ph: (269) 749-9477 | Main Street Dental Pllc 123 S Main St Olivet MI 49076-9404 Ph: (269) 749-9477 |
| NPI Number | 1679215818 |
|---|---|
| Provider Enumeration Date | 04/08/2022 |
| Last Update Date | 04/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679215818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |