Organization
MADISON PEDIATRIC DENTAL, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET WILL (OFFICE MANAGER)
(608) 222-6160
Entity
Organization
Contact information
Practice address
100 RIVER PL, SUITE 110, MADISON, WI 53716-4041
(608) 222-6160
(608) 222-6248
Mailing address
100 RIVER PL, SUITE 110, MADISON, WI 53716-4041
(608) 222-6160
(608) 222-6248
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33376600
—
WI
Enumeration date
11/09/2006
Last updated
08/22/2020
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