East Grove Dental SC
East Grove Dental SC provides General Practice Dentistry in Madison, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.
- Licensed in
- WI
- In the registry since
- 2006
- Specialties on file
- 3
Practice location Address checks out
826 Atlas AveMadison, WI 53714-3114
Phone: (608) 222-8344
Fax: (608) 222-8376
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 5133 (WI) |
|---|---|
| General Practice Dentistry | Taxonomy 1223G0001X · Licence 1727G (WI) |
| General Practice Dentistry | Taxonomy 1223G0001X · Licence 2808 (WI) |
Record details
| NPI number | 1023073178 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Sandra Lysloff — Office Administrator · (608) 222-8344 |
| NPI enumerated | April 20, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 826 Atlas Ave, Madison, WI 53714-3114 |
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