| Maple Grove Dental Sc | |
|
6627 Mckee Rd Madison WI 53719-5023 | |
| (608) 848-5680 | |
| (608) 848-5681 |
| Full Name | Maple Grove Dental Sc |
|---|---|
| Speciality | Dentist |
| Location | 6627 Mckee Rd, Madison, Wisconsin |
| Authorized Official Name and Position | James Carl Tauschek (OWNER/PRESIDENT) |
| Authorized Official Contact | 6088485680 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Grove Dental Sc 6627 Mckee Rd Madison WI 53719-5023 Ph: (608) 848-5680 | Maple Grove Dental Sc 6627 Mckee Rd Madison WI 53719-5023 Ph: (608) 848-5680 |
| NPI Number | 1134111974 |
|---|---|
| Provider Enumeration Date | 08/18/2005 |
| Last Update Date | 01/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134111974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | WI3998 (Wisconsin) | Primary |
| 122300000X | Dentist | 30018639 (Ohio) | Secondary |
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