| NPI | 1982399283 |
|---|---|
| Doing Business As | MAIN STREET DENTAL |
| Entity Type | Organization |
| Authorized Contact | DANIEL M JAVAHERI President 760-295-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-04-11 |