Main Street Dental LLC
NPI #1669846838 in Canon City, Colorado
Provider Information
- NPI Number
- 1669846838
- Entity Type
- Organization
- Organization Name
- Main Street Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 25, 2015
- Last Updated
- Feb 9, 2023
Practice Location
- Address
- 330 MAIN ST
- City
- Canon City
- State
- Colorado
- ZIP Code
- 81212-3732
- Phone
- (719) 275-3255
Authorized Official
- Name
- JACOB BEUS, DMD
- Title
- OWNER
- Phone
- (719) 275-3255
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment |
| Dentist - General Practice — General Practice |
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