Individual
RAYMOND MATTHEW MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1270 W MAIN ST, SUN PRAIRIE, WI 53590-1930
(608) 825-7100
Mailing address
1270 W MAIN ST, SUN PRAIRIE, WI 53590
(317) 432-4753
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011570A
IN
Other
Enumeration date
12/21/2010
Last updated
11/01/2012
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