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General NPI Number Information
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NPI Number | 1831961473
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Entity Type | Organization
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Legal Business Name | DEAN DENTAL GROUP LLC
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 2534 WINNEBAGO ST
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City | MADISON
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State | WI
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Zip | 53704-2860
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Country | US
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Telephone | 608-294-1960
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Fax | 608-294-1962
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Provider Business Mailing Address
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Address Line | 2534 WINNEBAGO ST
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City | MADISON
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State | WI
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Zip | 53704-2860
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Country | US
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Telephone | 608-294-1696
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Fax | 608-294-1962
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Authorized Official
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Title or Position | OWNER
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Name | SYED REHMAN
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Credential | DMD
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Telephone | 608-294-1960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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