| Ld-madison, Llc | |
|
306 Fountains Dr Madison MS 39110-6384 | |
| (601) 605-1410 | |
| (601) 605-1367 |
| Full Name | Ld-madison, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 306 Fountains Dr, Madison, Mississippi |
| Authorized Official Name and Position | Lizz Daigneault (ADMIN DIRECTOR) |
| Authorized Official Contact | 2567839468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ld-madison, Llc 306 Fountains Dr Madison MS 39110-6384 Ph: (601) 605-1410 | Ld-madison, Llc 306 Fountains Dr Madison MS 39110-6384 Ph: (601) 605-1410 |
| NPI Number | 1285415216 |
|---|---|
| Provider Enumeration Date | 10/05/2023 |
| Last Update Date | 11/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285415216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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