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Avery Fossum
NPI 1043905185 · on the registry since 2023 · sole proprietor
Practice
- Address
- 858 Jupiter Dr
Madison, WI 53718 - Phone
- (608) 222-7511
- Organisation at this address
- John C. Stacey Dds Sc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Sex
- Male
- Record last updated
- 2023-04-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin