# BRIAN E MAHONEY DMD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Main Street Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083291405
- **Authorized official:** JESSICA MILLER (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (360) 696-2513

## Contact information

- **Practice address:** 3512 MAIN ST, VANCOUVER, WA 98663-2224
- **Practice address phone:** (360) 696-2513
- **Mailing address:** 3512 MAIN ST, VANCOUVER, WA 98663-2224
- **Mailing address phone:** (360) 696-2513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/24/2021
- **Last updated:** 03/24/2021