Provider Demographics
NPI:1457407165
Name:MADDEN, FAITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 CLINT DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-7994
Mailing Address - Country:US
Mailing Address - Phone:614-367-1740
Mailing Address - Fax:614-367-1760
Practice Address - Street 1:164 CLINT DR
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7994
Practice Address - Country:US
Practice Address - Phone:614-367-1740
Practice Address - Fax:614-367-1760
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30022406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist