Provider Demographics
NPI:1326734278
Name:ALIGN ORTHODONTICS
Entity Type:Organization
Organization Name:ALIGN ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:WITCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-988-9001
Mailing Address - Street 1:3201 E OLIVE RD STE A
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-7237
Mailing Address - Country:US
Mailing Address - Phone:850-988-9001
Mailing Address - Fax:850-988-9002
Practice Address - Street 1:3201 E OLIVE RD STE A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-7237
Practice Address - Country:US
Practice Address - Phone:850-988-9001
Practice Address - Fax:850-988-9002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALIGN ORTHODONTICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty