Organization
MAIN STREET DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEYNA LEE BEHNAN DDS (PRESIDENT)
(810) 387-4746
Entity
Organization
Contact information
Practice address
210 S MAIN ST, YALE, MI 48097-3319
(810) 387-4746
Mailing address
210 S MAIN ST, YALE, MI 48097-3319
(810) 387-4746
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019511
MI
261QD0000X
Dental Clinic/Center
2901019511
MI
Other
Enumeration date
05/14/2012
Last updated
08/03/2012
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