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Organization
THE MAIN STREET DENTISTS INC
Active
Organization
THE MAIN STREET DENTISTS INC
Active
Other names
Jon David Mehr DDS & Martha Bridges Mehr DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON DAVID MEHR DDS (DR & PRESIDENT OF CORPORATION)
(352) 787-4800
Entity
Organization
Contact information
Practice address
606 W MAGNOLIA STREET, LEESBURG, FL 34748
(352) 787-4800
(352) 787-9091
Mailing address
606 W MAGNOLIA STREET, LEESBURG, FL 34748
(352) 787-4800
(352) 787-9091
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN0014763
FL
122300000X
Dentist
DN0014896
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1364448
UNITED CONCORDIA
—
01
—
36838
BLUE CROSS BLUE SHIELD
—
01
—
36839
BLUE CROSS BLUE SHIELD
—
01
—
749700
UNITED CONCORDIA
—
Enumeration date
12/04/2006
Last updated
09/04/2008
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