Organization
CALLAWAY FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX MADOV DDS (MEMBER)
(402) 850-9285
Entity
Organization
Contact information
Practice address
2424 N BLUFF ST, FULTON, MO 65251-2709
(573) 642-6904
Mailing address
2424 N BLUFF ST, FULTON, MO 65251-2709
(573) 642-6904
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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