Provider Demographics
NPI:1003687203
Name:NO FEAR DENTISTRY MADISON WEST LLC
Entity Type:Organization
Organization Name:NO FEAR DENTISTRY MADISON WEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DUCOMMUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-444-1419
Mailing Address - Street 1:344 S YELLOWSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705
Mailing Address - Country:US
Mailing Address - Phone:608-836-5700
Mailing Address - Fax:608-836-4621
Practice Address - Street 1:344 S YELLOWSTONE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705
Practice Address - Country:US
Practice Address - Phone:608-836-5700
Practice Address - Fax:608-836-4621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID S DUCOMMUN DDS SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty