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Organization
ST MARY'S DEAN VENTURES INC
Active
Organization
ST MARY'S DEAN VENTURES INC
Active
Other names
Breast Core Biopsy Center
Organization subpart
No
Provider details
NPI number
Authorized official
AMY J GRINNELL (CHIEF FINANCIAL OFFICE)
(608) 260-3586
Entity
Organization
Contact information
Practice address
1313 FISH HATCHERY ROAD, MADISON, WI 53715
(608) 252-7445
Mailing address
PO BOX 259317, 1808 W BELTLINE HWY, MADISON, WI 53725-9317
(608) 250-1316
(608) 250-1034
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32837200
—
WI
01
—
543668
DEAN HEALTH PLAN
WI
Enumeration date
11/14/2006
Last updated
10/29/2021
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