Daniel Raymond Maddigan, DDS

Individual provider Active NPI General Practice Dentistry · Beech Grove, IN

NPI 1679799100 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1679799100
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12009033 (IN)
Practice address
723 Main St
Beech Grove, IN 46107-1513
Phone
(317) 787-1361
Fax
(317) 788-7199
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12009033INMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12009033 IN Yes

Addresses

Primary practice location

723 Main St
Beech Grove, IN 46107-1513

Mailing address

723 Main St
Beech Grove, IN 46107-1513
Phone (317) 787-1361

Other providers in Beech Grove, IN

All providers in Beech Grove, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.