# MAIN STREET FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104990233
- **Authorized official:** DORIS ANN VANNATTER DDS (PRESIDENT OWNER)
- **Authorized official phone:** (317) 839-5500

## Contact information

- **Practice address:** 712 W MAIN STREET, SUITE 100, PLAINFIELD, IN 46168-9403
- **Practice address phone:** (317) 839-5550
- **Practice address fax:** (317) 839-5509
- **Mailing address:** 712 W MAIN STREET, SUITE 100, PLAINFIELD, IN 46168-9403
- **Mailing address phone:** (317) 839-5550
- **Mailing address fax:** (317) 839-5509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009821 | IN | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 08/22/2020