Orthodontic Specialists Of Madison | |
202 S Gammon Rd Ste. 150 Madison WI 53717-1400 | |
(608) 664-9500 | |
(608) 664-9566 |
Full Name | Orthodontic Specialists Of Madison |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 202 S Gammon Rd, Madison, Wisconsin |
Authorized Official Name and Position | Steven D. Peterson (PRESIDENT) |
Authorized Official Contact | 6086649500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Orthodontic Specialists Of Madison 202 S Gammon Rd Ste. 150 Madison WI 53717-1400 Ph: (608) 664-9500 | Orthodontic Specialists Of Madison 202 S Gammon Rd Ste. 150 Madison WI 53717-1400 Ph: (608) 664-9500 |
NPI Number | 1275667149 |
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Provider Enumeration Date | 03/15/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1275667149 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3613-015 (Wisconsin) | Primary |
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