Organization
MADISON SQUARE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BO DING DMD (DENTIST/MANAGER)
(404) 992-1241
Entity
Organization
Contact information
Practice address
1925 MADISON SQUARE BLVD, SUITE 500, LA VERGNE, TN 37086-4721
(404) 992-1241
Mailing address
1925 MADISON SQUARE BLVD, SUITE 500, LA VERGNE, TN 37086-4721
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
10117
TN
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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