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NPI Code Detail

MEDICARE: DR. MADISON PAIGE FUSTON DDS

MEDICARE:  DR. MADISON PAIGE FUSTON  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry37275TX

General Provider Information

NPI Number : 1003485418
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MADISON PAIGE FUSTON DDS
Provider Business Mailing Address
First Line : 7100 ALMEDA RD APT 526
Second Line :
City : HOUSTON
State : TX
Zip : 77054-2129
Country : US
Telephone Number : 409-289-1929
Fax Number :
Provider Business Practice Location Address
First Line : 3140 CENTRAL MALL DR
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77642-8039
Country : US
Telephone Number : 409-727-2164
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2021
Last Update Date : 06/21/2021

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Directions to “ DR. MADISON PAIGE FUSTON DDS” Practice Location

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