# MADISONDENTALGROUPLLC

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

## Provider details

- **NPI number:** 1568746097
- **Authorized official:** PENNY STROZIER (OFFICE MANAGER)
- **Authorized official phone:** (706) 474-0962

## Contact information

- **Practice address:** 1040 BARCLAY DR, MADISON, GA 30650-4621
- **Practice address phone:** (706) 342-1242
- **Mailing address:** 1040 BARCLAY DR, MADISON, GA 30650-4621
- **Mailing address phone:** (706) 342-1242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/03/2011
- **Last updated:** 10/03/2011