Organization
QUIRT FAMILY DENTISTRY, SC
Active
Parent organization
QUIRT FAMILY DENTISTRY, SC
Other names
Four Lakes Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUIRT FAMILY DENTISTRY, SC
Authorized official
KENDRA WALKER (CREDENTIALING TEAM LEAD)
(217) 540-8312
Entity
Organization
Contact information
Practice address
6038 GEMINI DRIVE, MADISON, WI 53718
(608) 807-1524
Mailing address
6038 GEMINI DRIVE, MADISON, WI 53718
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/17/2016
Last updated
03/11/2016
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