Organization
DENTISTRY FOR MADISON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANN KIELLEY CORBETT (OFFICE MANAGER)
(608) 251-8790
Entity
Organization
Contact information
Practice address
413 W WASHINGTON AVE, MADISON, WI 53703-2703
(608) 251-8790
(608) 251-0242
Mailing address
413 W WASHINGTON AVE, MADISON, WI 53703-2703
(608) 251-8790
(608) 251-0242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4304
WI
1223G0001X
General Practice Dentistry
5169
WI
Other
Enumeration date
02/19/2008
Last updated
02/19/2008
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