Individual
MADISON TAYLOR OPHAUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3710 13TH AVE, BROOKLYN, NY 11218-3602
(718) 686-7600
Mailing address
3710 13TH AVE, BROOKLYN, NY 11218-3602
(718) 686-7600
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
064415
NY
1223P0221X
Pediatric Dentistry
22DI03020400
NJ
Other
Enumeration date
04/14/2022
Last updated
07/10/2025
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