Main Street Dental
NPI #1124150248 in New Prague, Minnesota
Provider Information
- NPI Number
- 1124150248
- Entity Type
- Organization
- Organization Name
- Main Street Dental
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 12, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 301 MAIN ST E
- Address 2
- SUITE 2
- City
- New Prague
- State
- Minnesota
- ZIP Code
- 56071-1803
- Phone
- (952) 758-2376
Authorized Official
- Name
- MS. PAULA JULIE NOVAK
- Title
- OFFICE MANAGER
- Phone
- (952) 758-2376
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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Organizations
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