Organization
UNIVERSITY PT ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANINE HANSON (PRACTICE MANAGER)
(205) 979-9480
Entity
Organization
Contact information
Practice address
641 HELEN KELLER BLVD, TUSCALOOSA, AL 35404-2983
(205) 553-2524
Mailing address
2034 PATTON CHAPEL ROAD, HOOVER, AL 35216
(205) 979-9480
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/27/2019
Last updated
09/27/2019
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