Main Street Dental, LLC

NPI #1154570448 in Pratt, Kansas

Provider Information

NPI Number: 1154570448
Entity Type: Organization
Organization Name: Main Street Dental, LLC
Primary Specialty: Dentist
Enumeration Date: Sep 11, 2008
Last Updated: Feb 10, 2009

Practice Location

Address: 603 S MAIN ST
City: Pratt
State: Kansas
ZIP Code: 67124-2630
Phone: (620) 672-9922

Authorized Official

Name: DR. JOHN D. MATHES, DDS
Title: OWNER
Phone: (620) 672-9922

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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