Main St Dental PLLC
Dentist, General Practice in Alton, TX. Organization (NPI-2).
NPI number1164089645
StatusActive
Last updated in NPPESMay 21, 2019
Details
- NPI
- 1164089645
- Entity type
- Organization (NPI-2)
- Legal business name
- Main St Dental PLLC
- Organization subpart
- No
- Enumeration date
- May 21, 2019
- Last updated
- May 21, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
921 E Main Ave Ste 2Alton, TX 78573-1606
Phone 956-583-5050 · Fax 956-583-5067
Mailing address
921 E Main Ave Ste 2Alton, TX 78573-1606
Phone 956-583-5050 · Fax 956-583-5067
Authorized official
Patrick Whilby
Owner/Dentist
9565835050
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