The Main Street Dentists INC

NPI #1265500565 in Leesburg, Florida

Provider Information

NPI Number: 1265500565
Entity Type: Organization
Organization Name: The Main Street Dentists INC
Primary Specialty: Dentist
Enumeration Date: Dec 4, 2006
Last Updated: Sep 4, 2008

Practice Location

Address: 606 W MAGNOLIA STREET
City: Leesburg
State: Florida
ZIP Code: 34748
Phone: (352) 787-4800

Authorized Official

Name: DR. JON DAVID MEHR, DDS
Title: DR & PRESIDENT OF CORPORATION
Phone: (352) 787-4800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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