| NPI | 1871145219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON BOGGAN Owner/President/Orthodontist 205-664-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-16 |