Main Street Dental, Pllc
NPI #1679072664 in Locust Grove, Oklahoma
Provider Information
- NPI Number
- 1679072664
- Entity Type
- Organization
- Organization Name
- Main Street Dental, Pllc
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Feb 6, 2018
- Last Updated
- Mar 2, 2018
Practice Location
- Address
- 409 E MAIN ST
- City
- Locust Grove
- State
- Oklahoma
- ZIP Code
- 74352-5116
- Phone
- (918) 845-5505
Authorized Official
- Name
- DR. DAVID HENRY, DDS
- Title
- OWNER
- Phone
- (918) 479-8020
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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