Organization
MAIN STREET DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT ALLEN NULL DDS (PRESIDENT OWNER)
(740) 344-4000
Entity
Organization
Contact information
Practice address
1339 W MAIN ST, NEWARK, OH 43055
(740) 344-4000
(740) 344-3139
Mailing address
1822 SUTTON PLACE, NEWARK, OH 43055
(740) 344-4410
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
OH15386
OH
Other
Enumeration date
11/03/2006
Last updated
08/01/2007
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