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Organization
WIREGRASS ORTHODONTIC SPECIALISTS
Active
Organization
WIREGRASS ORTHODONTIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI MCCLINTOCK (INSURANCE)
(334) 792-1000
Entity
Organization
Contact information
Practice address
100 OBRANNON PARK AVE, DOTHAN, AL 36303-2052
(334) 792-1000
Mailing address
100 OBRANNON PARK AVE, DOTHAN, AL 36303-2052
(334) 792-1000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5050
AL
Other
Enumeration date
03/05/2018
Last updated
03/05/2018
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