Individual
ANDREW WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2800 COLLEGE AVE, ALTON, IL 62002-4742
(618) 474-7000
Mailing address
2800 COLLEGE AVE, ALTON, IL 62002-4742
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031307
IL
Other
Enumeration date
08/19/2017
Last updated
08/19/2017
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