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General NPI Number Information
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NPI Number | 1053578591
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Entity Type | Organization
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Legal Business Name | MATTHEW D. LITZ, D.D.S., LLC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 400 CENTURY PARK S SUITE 200
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City | BIRMINGHAM
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State | AL
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Zip | 35226-3945
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Country | US
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Telephone | 205-822-3222
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Fax | 205-822-3504
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Provider Business Mailing Address
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Address Line | 400 CENTURY PARK S SUITE 200
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City | BIRMINGHAM
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State | AL
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Zip | 35226-3945
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Country | US
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Telephone | 205-822-3222
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Fax | 205-822-3504
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW DAVID LITZ
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Credential |
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Telephone | 205-822-3222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 5543
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License Number State | AL
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