Organization
DENTAL IMPLANTS & PERIODONTAL SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STELLA MARIE HULSE-CRISTOFORO (CFO)
(516) 835-6777
Entity
Organization
Contact information
Practice address
6601 MINERAL POINT RD, MADISON, WI 53705-4239
(608) 841-1600
(608) 841-1602
Mailing address
6601 MINERAL POINT RD, MADISON, WI 53705-4239
(608) 841-1600
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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