Organization
MAIN STREET DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CLYDE HARTLEY DDS (OWNER)
(508) 939-9000
Entity
Organization
Contact information
Practice address
207 UPPER MAIN ST, EDGARTOWN, MA 02539-5927
(508) 939-9000
(508) 939-8537
Mailing address
PO BOX 2135, EDGARTOWN, MA 02539-2135
(508) 939-9000
(508) 939-8537
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19314
MA
Other
Enumeration date
01/21/2010
Last updated
01/21/2010
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