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Organization
ELLICKSON DENTAL LLC
Active
Organization
ELLICKSON DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE ELLICKSON DDS (OWNER)
(417) 569-6575
Entity
Organization
Contact information
Practice address
5510 MEDICAL CIR, MADISON, WI 53719-1239
(608) 274-5510
Mailing address
5510 MEDICAL CIR, MADISON, WI 53719-1239
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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