Healthcare Provider Details

I. General information

NPI: 1558059444
Provider Name (Legal Business Name): JAMES M. SITZ DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12475 US HIGHWAY 90
GRAND BAY AL
36541-5796
US

IV. Provider business mailing address

13037 GASTON LOOP RD
GRAND BAY AL
36541-3414
US

V. Phone/Fax

Practice location:
  • Phone: 251-865-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES M. SITZ
Title or Position: OWNER
Credential: DDS
Phone: 337-396-1228