# MAIN STREET DENTAL, INC

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

## Provider details

- **NPI number:** 1346390903
- **Authorized official:** KUONG C KOV DDS (PRESIDENT)
- **Authorized official phone:** (480) 833-3677

## Contact information

- **Practice address:** 67 N DOBSON RD, MESA, AZ 85201-6822
- **Practice address phone:** (480) 833-3677
- **Practice address fax:** (480) 833-0566
- **Mailing address:** 67 N DOBSON RD, MESA, AZ 85201-6822
- **Mailing address phone:** (480) 833-3677
- **Mailing address fax:** (480) 833-0566

## Taxonomy

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

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 08/22/2020