MAIN STREET DENTAL, PLLC
NPI 1679072664
Clinic/Center - Dental in Locust Grove, OK
Active since February 06, 2018
About Main Street Dental, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAIN STREET DENTAL, PLLC (NPI 1679072664) is a healthcare organization registered as a dental in Locust Grove, Oklahoma and active in the NPI registry since February 2018. The organization lists David Henry, Owner, as its authorized official.
NPPES Registry Identity
NPI1679072664
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameMAIN STREET DENTAL, PLLC
Location Address409 E MAIN STLocust Grove, OK 74352-5116
Mailing Address1707 Forest Hill DrClaremore, OK 74017 · (918) 845-5505
Phone(918) 845-5505
Organization SubpartNo
Authorized OfficialDavid HenryOwner · (918) 479-8020
Enumeration DateFebruary 6, 2018
Last NPPES UpdateMarch 2, 2018
✔ NPI 1679072664 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in OK · 6531
409 E MAIN ST, Locust Grove, OK 74352
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1679072664, enumerated as an "organization" on February 06, 2018.
The provider is located at 409 E MAIN ST LOCUST GROVE, OK 74352 and the phone number is (918) 845-5505.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
