| Familia Dental Madison East Llc | |
|
3003 E Washington Ave Madison WI 53704-4301 | |
| (888) 988-4066 | |
| (847) 496-4850 |
| Full Name | Familia Dental Madison East Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3003 E Washington Ave, Madison, Wisconsin |
| Authorized Official Name and Position | Ivonne Tellez (ENROLLMENT TEAM LEAD) |
| Authorized Official Contact | 8889884066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental Madison East Llc 2050 E Algonquin Rd Suite 610 Schaumburg IL 60173-4144 Ph: (888) 988-4066 | Familia Dental Madison East Llc 3003 E Washington Ave Madison WI 53704-4301 Ph: (888) 988-4066 |
| NPI Number | 1821451428 |
|---|---|
| Provider Enumeration Date | 03/31/2016 |
| Last Update Date | 10/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821451428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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