Organization
UNIVERSITY ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER JASON GOLTZ DMD MS (OWNER/ORTHODONTIST)
(205) 553-2524
Entity
Organization
Contact information
Practice address
641 HELEN KELLER BLVD, TUSCALOOSA, AL 35404-2983
(205) 553-2524
(205) 553-6617
Mailing address
641 HELEN KELLER BLVD, TUSCALOOSA, AL 35404-2983
(205) 553-2524
(205) 553-6617
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5557
AL
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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