Organization
AESTHETIC AND RECONSTRUCTIVE DENTISTRY, LLC
Active
Other names
Madison Prosthodontics: Aesthetic and Reconstructive Dentistry, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAMIN PETER WILTZ II DMD, CDT (SOLE MEMBER)
(256) 319-3256
Entity
Organization
Contact information
Practice address
1041 BALCH RD, SUITE 180, MADISON, AL 35758-8343
(256) 319-3256
(256) 319-3257
Mailing address
1041 BALCH RD, SUITE 180, MADISON, AL 35758-8343
(256) 319-3256
(256) 319-3257
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
5928
AL
292200000X
Dental Laboratory
233720-00
AL
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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