| Monroe Street Family Dental, Llc | |
|
2702 Monroe St Madison WI 53711-1888 | |
| (608) 204-0222 | |
| (608) 240-0224 |
| Full Name | Monroe Street Family Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2702 Monroe St, Madison, Wisconsin |
| Authorized Official Name and Position | Benjamin Joseph Farrow (MEMBER) |
| Authorized Official Contact | 6082040222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Monroe Street Family Dental, Llc 2702 Monroe St Madison WI 53711-1888 Ph: (608) 204-0222 | Monroe Street Family Dental, Llc 2702 Monroe St Madison WI 53711-1888 Ph: (608) 204-0222 |
| NPI Number | 1184959405 |
|---|---|
| Provider Enumeration Date | 10/04/2009 |
| Last Update Date | 10/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184959405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5964-015 (Wisconsin) | Primary |
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