MEDICARE: MADISON ENDODONTIC ASSOCIATES S.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics		WI

General Provider Information

NPI Number	:	1326045030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADISON ENDODONTIC ASSOCIATES S.C

Provider Business Mailing Address
First Line	:	2921 LANDMARK PL STE 220
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53713-4248
Country	:	US
Telephone Number	:	608-310-3636
Fax Number	:	608-906-3636

Provider Business Practice Location Address
First Line	:	2921 LANDMARK PL STE 220
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53713-4248
Country	:	US
Telephone Number	:	608-310-3636
Fax Number	:	608-906-3636

Authorized Official
Title or Position	:	PATIENT CARE COORDINATOR
Name	:	CORRINE MCAULIFFE
Credential	:
Telephone Number	:	608-310-3636

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/07/2025

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