| Four Lakes Family Dental | |
|
6038 Gemini Drive Madison WI 53718 | |
| (608) 807-1524 | |
| Not Available |
| Full Name | Four Lakes Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6038 Gemini Drive, Madison, Wisconsin |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Lakes Family Dental 6038 Gemini Drive Madison WI 53718 Ph: () - | Four Lakes Family Dental 6038 Gemini Drive Madison WI 53718 Ph: (608) 807-1524 |
| NPI Number | 1811356926 |
|---|---|
| Provider Enumeration Date | 02/17/2016 |
| Last Update Date | 03/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811356926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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