Organization
MAIN STREET DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULA JULIE NOVAK (OFFICE MANAGER)
(952) 758-2376
Entity
Organization
Contact information
Practice address
301 MAIN ST E, SUITE 2, NEW PRAGUE, MN 56071-1803
(952) 758-2376
(952) 758-8708
Mailing address
301 MAIN ST E, SUITE 2, NEW PRAGUE, MN 56071-1803
(952) 758-2376
(952) 758-8708
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/12/2007
Last updated
08/22/2020
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