Healthcare Provider Details

I. General information

NPI: 1891071932
Provider Name (Legal Business Name): TAMMY DOWNING RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2011
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 N CARROLL ST #501
MADISON WI
53703-2211
US

IV. Provider business mailing address

211 N CARROLL ST # 501
MADISON WI
53703-2211
US

V. Phone/Fax

Practice location:
  • Phone: 608-258-2400
  • Fax: 608-258-2482
Mailing address:
  • Phone: 608-258-2400
  • Fax: 608-258-2482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number399616
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: