Organization
MADISON DENTAL, DDS, PC
Active
Other names
Madison Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS RODQUAE BOSTON DDS (OWNER)
(202) 491-5781
Entity
Organization
Contact information
Practice address
566 FM 1960 RD W STE 400, HOUSTON, TX 77090-3544
(202) 491-5781
Mailing address
566 FM 1960 RD W STE 400, HOUSTON, TX 77090-3544
(202) 491-5781
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
25589
TX
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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