Healthcare Provider Details

I. General information

NPI: 1154354249
Provider Name (Legal Business Name): DENTAL HEALTH ASSOCIATES OF MADISON, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2971 CHAPEL VALLEY RD ADMINISTRATION OFFICE
FITCHBURG WI
53711-7420
US

IV. Provider business mailing address

2971 CHAPEL VALLEY RD
FITCHBURG WI
53711-7420
US

V. Phone/Fax

Practice location:
  • Phone: 608-661-6432
  • Fax:
Mailing address:
  • Phone: 608-661-6432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLEN J SKIBBA
Title or Position: PRIVACY OFFICER
Credential: DDS
Phone: 608-246-2555