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Organization

KRISTIN MAIN DDS, PLLC

Active
Other names
Main Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN L MAIN DDS (OWNER DENTIST)
(616) 403-1510
Entity
Organization

Contact information

Practice address
110 VILLAGE RD NE UNIT A, LELAND, NC 28451-7412
(910) 371-0966
(910) 371-0968
Mailing address
110 VILLAGE RD NE UNIT A, LELAND, NC 28451-7412
(910) 371-0966
(910) 371-0968

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1609005859
NC
Enumeration date
08/05/2022
Last updated
08/05/2022
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