Provider Demographics
NPI:1487106852
Name:DENTAL HEALTH ASSOCIATES OF MADISON
Entity type:Organization
Organization Name:DENTAL HEALTH ASSOCIATES OF MADISON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-661-6427
Mailing Address - Street 1:2971 CHAPEL VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-7420
Mailing Address - Country:US
Mailing Address - Phone:608-442-4433
Mailing Address - Fax:608-442-4388
Practice Address - Street 1:2971 CHAPEL VALLEY RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-7420
Practice Address - Country:US
Practice Address - Phone:608-442-4433
Practice Address - Fax:608-442-4388
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL HEALTH ASSOCIATES OF MADISON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty