Individual
MADISON M TALIAFERRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
372 CORAL RD, MALVERN, AR 72104-7108
(501) 337-9212
(501) 337-0280
Mailing address
372 CORAL RD, MALVERN, AR 72104-7108
(501) 337-9212
(501) 337-0280
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2594
AR
Other
Enumeration date
03/17/2008
Last updated
03/17/2008
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