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Organization

BRIAN E MAHONEY DMD

Active
Other names
Main Street Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA MILLER (PRACTICE ADMINISTRATOR)
(360) 696-2513
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
03/24/2021
Last updated
03/24/2021
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