Organization
MADISON DENTAL DRE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH DAVIS (DIRECTOR OF REVENUE)
(859) 533-1109
Entity
Organization
Contact information
Practice address
308 HIGHLAND PARK DR STE 8174, RICHMOND, KY 40475-3487
(859) 626-9851
Mailing address
105 SPRUCE ST, LEXINGTON, KY 40507-2109
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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