Individual
DR. JEFFREY S MADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
17490 STATE ROAD 23, SOUTH BEND, IN 46635-1743
(574) 271-9000
(574) 273-1624
Mailing address
17490 STATE ROAD 23, SOUTH BEND, IN 46635-1743
(574) 271-9000
(574) 273-1624
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009190
IN
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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