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General NPI Number Information
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NPI Number | 1336724160
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Entity Type | Individual
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Provider Name | ANDREA IVY GEFFIN DMD
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Gender | Female
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Dates
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Enumeration Date | 03/12/2021
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 440 SCIENCE DR STE 100
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City | MADISON
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State | WI
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Zip | 53711-1064
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Country | US
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Telephone | 608-836-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 2409 PARMENTER ST APT 402
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City | MIDDLETON
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State | WI
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Zip | 53562-2687
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Country | US
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Telephone | 203-695-8797
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6001472
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License Number State | WI
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