Organization
ORTHODONTICS SOUTH, PC
Active
Organization
ORTHODONTICS SOUTH, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON BOGGAN (OWNER/PRESIDENT/ORTHODONTIST)
(205) 664-4140
Entity
Organization
Contact information
Practice address
2705 PELHAM PKWY STE 200, PELHAM, AL 35124-1704
(205) 664-4140
Mailing address
2705 PELHAM PKWY STE 200, PELHAM, AL 35124-1704
(205) 664-4140
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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