Provider Demographics
NPI:1629460506
Name:TW ORTHODONTICS LLC
Entity Type:Organization
Organization Name:TW ORTHODONTICS LLC
Other - Org Name:MONTGOMERY ORTHODONTIC SPECIALISTS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-347-0096
Mailing Address - Street 1:736 E LEE ST
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2478
Mailing Address - Country:US
Mailing Address - Phone:334-347-0096
Mailing Address - Fax:
Practice Address - Street 1:736 E LEE ST
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2478
Practice Address - Country:US
Practice Address - Phone:334-347-0096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL57081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty