| Madison Dental Llc | |
|
2110 Fordem Ave Madison WI 53704-4610 | |
| (608) 244-9124 | |
| Not Available |
| Full Name | Madison Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2110 Fordem Ave, Madison, Wisconsin |
| Authorized Official Name and Position | Kelly Bares (OWNER) |
| Authorized Official Contact | 3093693284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Dental Llc 2110 Fordem Ave Madison WI 53704-4610 Ph: () - | Madison Dental Llc 2110 Fordem Ave Madison WI 53704-4610 Ph: (608) 244-9124 |
| NPI Number | 1417476458 |
|---|---|
| Provider Enumeration Date | 09/11/2017 |
| Last Update Date | 09/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417476458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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