Organization
EVANS/KOEN MAIN ST DENTAL PLLC
Active
Other names
Main Street Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN DEXTER KOEN DMD (PARTNER)
(512) 295-9925
Entity
Organization
Contact information
Practice address
108 S MAIN ST, BUDA, TX 78610-3375
(512) 295-9925
Mailing address
108 S MAIN ST, BUDA, TX 78610-3375
(512) 295-9925
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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