NPI: 1902297690
Provider Name: AESTHETIC AND RECONSTRUCTIVE DENTISTRY, LLC
Doing Business As: MADISON PROSTHODONTICS: AESTHETIC AND RECONSTRUCTIVE DENTISTRY, LLC
Classification: Dentist - 1223P0700X
Entity Type: Organization
Specialization: Prosthodontics
CLIA Number: 01D2021281
Address:
1041 BALCH RD
SUITE 180
MADISON, AL
ZIP 35758
Phone: (256) 319-3256
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AESTHETIC AND RECONSTRUCTIVE DENTISTRY, LLC is a prosthodontics dentist in Madison, AL. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. AESTHETIC AND RECONSTRUCTIVE DENTISTRY, LLC NPI is 1902297690. The provider is registered as an organization entity type.
The provider Is Doing Business As Madison Prosthodontics: Aesthetic And Reconstructive Dentistry, Llc.
The provider's business location address is:
1041 BALCH RD
SUITE 180
MADISON, AL
ZIP 35758-343
Phone: (256) 319-3256
Fax: (256) 319-3257
The provider's authorized official is Cramin Peter Wiltz .
The authorized official title is Sole Member and has the following contact phone number (256) 319-3256.
The CLIA number assigned to this NPI record is 01D2021281 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/17/2015 and was last updated on 2/17/2015.