Organization
WISCONSIN DENTAL GROUP, S.C.
Active
Parent organization
WISCONSIN DENTAL GROUP, S.C.
Other names
ForwardDental Madison West
Organization subpart
Yes
Provider details
NPI number
Legal business name
WISCONSIN DENTAL GROUP, S.C.
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
2 SCIENCE CT STE 100, MADISON, WI 53711-1090
(262) 542-8860
(262) 524-9225
Mailing address
2 SCIENCE CT STE 100, MADISON, WI 53711-1090
(262) 542-8860
(262) 524-9225
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
04/15/2022
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