# MAIN STREET DENTAL - MULLICA HILL

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

## Provider details

- **NPI number:** 1295264521
- **Authorized official:** KEITH DUNOFF (OWNER)
- **Authorized official phone:** (856) 223-0041

## Contact information

- **Practice address:** 1 WHEATLEY BLVD, MULLICA HILL, NJ 08062-9622
- **Practice address phone:** (856) 223-0041
- **Practice address fax:** (856) 223-0020
- **Mailing address:** 1030 SAINT GEORGES AVE, AVENEL, NJ 07001-1390

## Taxonomy

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

## Other

- **Enumeration date:** 06/09/2017
- **Last updated:** 06/09/2017