| NPI | 1386295426 |
|---|---|
| Doing Business As | MAIN STREET DENTAL |
| Entity Type | Organization |
| Authorized Contact | SOOJIN LEE Dentist/Owner 865-300-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |