Madison Park Dental Center

NPI #1831545102 in Rexburg, Idaho

Provider Information

NPI Number
1831545102
Entity Type
Organization
Organization Name
Madison Park Dental Center
Primary Specialty
Dentist - General Practice
Enumeration Date
May 5, 2016
Last Updated
May 5, 2016

Practice Location

Address
35 MADISON PROFESSIONAL PARK
State
Idaho
ZIP Code
83440-2057
Phone
(208) 356-5601

Authorized Official

Name
DR. MARK A TALL
Title
OWNER
Phone
(208) 356-5601

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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