Provider Demographics
NPI:1134806755
Name:MUELLER, MADISON PAIGE (DDS)
Entity type:Individual
Prefix:DR
First Name:MADISON
Middle Name:PAIGE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 26TH AVE SE UNIT 305
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3444
Mailing Address - Country:US
Mailing Address - Phone:701-425-6593
Mailing Address - Fax:
Practice Address - Street 1:8977 HUNTERS WAY
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-9486
Practice Address - Country:US
Practice Address - Phone:952-206-4706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND149341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice