Organization
MADAN PERIODONTICS AND IMPLANT DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONIKA MADAN DDS DSC (PERIODONTIST/CEO)
(757) 663-1633
Entity
Organization
Contact information
Practice address
5900 E VIRGINIA BEACH BLVD STE 213, NORFOLK, VA 23502-2487
(757) 461-3660
Mailing address
5900 E VIRGINIA BEACH BLVD STE 213, NORFOLK, VA 23502-2487
(757) 461-3660
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401412643
VA
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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