Provider Demographics
NPI:1982032017
Name:HUEY PIERCE MADION II, D.D.S., P.C.
Entity Type:Organization
Organization Name:HUEY PIERCE MADION II, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF DENTAL SURGERY
Authorized Official - Prefix:DR
Authorized Official - First Name:HUEY
Authorized Official - Middle Name:PIERCE
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-336-0333
Mailing Address - Street 1:3511 DIMOND AVE
Mailing Address - Street 2:THE MADISON DENTAL BUILDING
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2210
Mailing Address - Country:US
Mailing Address - Phone:510-336-0333
Mailing Address - Fax:510-336-0335
Practice Address - Street 1:3511 DIMOND AVE
Practice Address - Street 2:THE MADISON DENTAL BUILDING
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-2210
Practice Address - Country:US
Practice Address - Phone:510-336-0333
Practice Address - Fax:510-336-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45728261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental