Organization
MADISON DENTAL INITIATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA ANN BELL BASDH, MPH-D (DIRECTOR)
(608) 497-0275
Entity
Organization
Contact information
Practice address
630 E WASHINGTON AVE, MADISON, WI 53703-2917
(608) 256-2321
Mailing address
3834 COSGROVE DR, MADISON, WI 53719-1856
(608) 497-0275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5729-015
WI
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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