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General NPI Number Information
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NPI Number | 1982032017
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Entity Type | Organization
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Legal Business Name | HUEY PIERCE MADION II, D.D.S., P.C.
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 12/24/2013
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Provider Practice Location Address
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Address Line | 3511 DIMOND AVE THE MADISON DENTAL BUILDING
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City | OAKLAND
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State | CA
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Zip | 94602-2210
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Country | US
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Telephone | 510-336-0333
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Fax | 510-336-0335
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Provider Business Mailing Address
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Address Line | 3511 DIMOND AVE THE MADISON DENTAL BUILDING
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City | OAKLAND
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State | CA
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Zip | 94602-2210
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Country | US
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Telephone | 510-336-0333
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Fax | 510-336-0335
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Authorized Official
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Title or Position | DOCTOR OF DENTAL SURGERY
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Name | DR. HUEY PIERCE MADISON II
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Credential | D.D.S.
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Telephone | 510-336-0333
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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 | 45728
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License Number State | CA
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