# MADISON DENTAL CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568238509
- **Authorized official:** ARIEL LEE STONE LDA/OM (OFFICE MANAGER)
- **Authorized official phone:** (320) 598-7433

## Contact information

- **Practice address:** 622 W 3RD ST, MADISON, MN 56256-1326
- **Practice address phone:** (320) 598-7433
- **Practice address fax:** (320) 598-7770
- **Mailing address:** 622 W 3RD ST, MADISON, MN 56256-1326
- **Mailing address phone:** (320) 598-7433
- **Mailing address fax:** (320) 598-7770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/30/2023
- **Last updated:** 11/30/2023