# MATC DENTAL HYGIENE CLINIC

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

## Provider details

- **NPI number:** 1881842672
- **Authorized official:** E. LYNN GOETSCH RDH (CLINIC SUPERVISOR)
- **Authorized official phone:** (608) 258-2470

## Contact information

- **Practice address:** 211 N CARROLL ST, MADISON, WI 53703-2211
- **Practice address phone:** (608) 258-2400
- **Mailing address:** 211 N CARROLL ST, MADISON, WI 53703-2211
- **Mailing address phone:** (608) 258-2400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 124Q00000X | Dental Hygienist | — | NULL | Yes |
| 124Q00000X | Dental Hygienist | — | — | Yes |

## Other

- **Enumeration date:** 09/04/2008
- **Last updated:** 09/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 38382500 | — | WI |