Organization
JIM MADANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY HOENICKE (PRACTICE ADMINISTRATOR)
(248) 689-2041
Entity
Organization
Contact information
Practice address
3515 ROCHESTER RD, TROY, MI 48083-5212
(248) 689-2041
(248) 689-2160
Mailing address
3515 ROCHESTER RD, TROY, MI 48083-5212
(248) 689-2041
(248) 689-2160
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2021
Last updated
09/13/2021
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