Monroe Street Family Dental, Llc | |
2702 Monroe St Madison WI 53711-1888 | |
(608) 204-0222 | |
(608) 240-0224 |
Full Name | Monroe Street Family Dental, Llc |
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Speciality | Clinic/center - Dental |
Location | 2702 Monroe St, Madison, Wisconsin |
Authorized Official Name and Position | Benjamin Joseph Farrow (MEMBER) |
Authorized Official Contact | 6082040222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Monroe Street Family Dental, Llc 2702 Monroe St Madison WI 53711-1888 Ph: (608) 204-0222 | Monroe Street Family Dental, Llc 2702 Monroe St Madison WI 53711-1888 Ph: (608) 204-0222 |
NPI Number | 1184959405 |
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Provider Enumeration Date | 10/04/2009 |
Last Update Date | 10/04/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184959405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 5964-015 (Wisconsin) | Primary |
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