Provider Demographics
NPI:1568594562
Name:ENDODONTIC SPECIALISTS OF MADISON, S.C.
Entity Type:Organization
Organization Name:ENDODONTIC SPECIALISTS OF MADISON, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:608-833-7424
Mailing Address - Street 1:7633 GANSER WAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2092
Mailing Address - Country:US
Mailing Address - Phone:608-833-7424
Mailing Address - Fax:608-833-9130
Practice Address - Street 1:7633 GANSER WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2092
Practice Address - Country:US
Practice Address - Phone:608-833-7424
Practice Address - Fax:608-833-9130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty