Main Street Dental INC
Dentist in Newark, OH. Organization (NPI-2).
NPI number1487733960
StatusActive
Last updated in NPPESAug 1, 2007
Details
- NPI
- 1487733960
- Entity type
- Organization (NPI-2)
- Legal business name
- Main Street Dental INC
- Organization subpart
- No
- Enumeration date
- Nov 3, 2006
- Last updated
- Aug 1, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | OH15386 | OH | Yes |
Practice location
1339 W Main StNewark, OH 43055
Phone 740-344-4000 · Fax 740-344-3139
Mailing address
1822 Sutton PlaceNewark, OH 43055
Phone 740-344-4410
Authorized official
Scott Allen Null
President Owner
7403444000
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