Organization
ORTHODONTIC SPECIALISTS OF MADISON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN D. PETERSON D.D.S.,M.S. (PRESIDENT)
(608) 664-9500
Entity
Organization
Contact information
Practice address
202 S GAMMON RD, STE. 150, MADISON, WI 53717-1400
(608) 664-9500
(608) 664-9566
Mailing address
202 S GAMMON RD, STE. 150, MADISON, WI 53717-1400
(608) 664-9500
(608) 664-9566
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3613-015
WI
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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