Organization
MONROE STREET FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN JOSEPH FARROW D.D.S (MEMBER)
(608) 204-0222
Entity
Organization
Contact information
Practice address
2702 MONROE ST, MADISON, WI 53711-1888
(608) 204-0222
(608) 240-0224
Mailing address
2702 MONROE ST, MADISON, WI 53711-1888
(608) 204-0222
(608) 240-0224
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5964-015
WI
Other
Enumeration date
10/04/2009
Last updated
10/04/2009
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