| Madison Dental Initiative | |
|
630 E Washington Ave Madison WI 53703-2917 | |
| (608) 256-2321 | |
| Not Available |
| Full Name | Madison Dental Initiative |
|---|---|
| Speciality | Dentist |
| Location | 630 E Washington Ave, Madison, Wisconsin |
| Authorized Official Name and Position | Lisa Ann Bell (DIRECTOR) |
| Authorized Official Contact | 6084970275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Dental Initiative 3834 Cosgrove Dr Madison WI 53719-1856 Ph: (608) 497-0275 | Madison Dental Initiative 630 E Washington Ave Madison WI 53703-2917 Ph: (608) 256-2321 |
| NPI Number | 1760719827 |
|---|---|
| Provider Enumeration Date | 11/11/2009 |
| Last Update Date | 11/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760719827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5729-015 (Wisconsin) | Primary |
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