Familia Dental Madison East LLC

Organization Active NPI Dental Clinic/Center · Madison, WI

NPI 1821451428 · NPPES record last updated Oct 15, 2021

Key facts

NPI
1821451428
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
Legal business name
FAMILIA DENTAL MADISON EAST LLC
Practice address
3003 E Washington Ave
Madison, WI 53704-4301
Phone
(888) 988-4066
Fax
(847) 496-4850
NPI assigned
Mar 31, 2016
Organization subpart
No

Authorized official

Name
Ivonne Tellez
Title
Enrollment Team Lead
Phone
(888) 988-4066

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

3003 E Washington Ave
Madison, WI 53704
Phone (608) 244-8050

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X
Dental Clinic/Center 261QD0000X Yes

Addresses

Primary practice location

3003 E Washington Ave
Madison, WI 53704-4301

Mailing address

2050 E Algonquin Rd
Suite 610
Schaumburg, IL 60173-4144
Phone (888) 988-4066

Other providers in Madison, WI

All providers in Madison, WI · Dental Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.