| NPI | 1104330950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER JASON GOLTZ Owner/Orthodontist 205-553-2524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AL 5557) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |