Main Street Family Denistry

NPI #1477652378 in Longmont, Colorado

Provider Information

NPI Number: 1477652378
Entity Type: Organization
Organization Name: Main Street Family Denistry
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 21, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1246 N MAIN ST
City: Longmont
State: Colorado
ZIP Code: 80501
Phone: (303) 678-7800

Authorized Official

Name: DR. THOMAS P DRAKE JR., DDS
Title: OWNER
Phone: (303) 678-7800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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