Provider Demographics
NPI:1962835553
Name:WILTZ, CRAMIN PETER II (DMD, CDT)
Entity Type:Individual
Prefix:DR
First Name:CRAMIN
Middle Name:PETER
Last Name:WILTZ
Suffix:II
Gender:M
Credentials:DMD, CDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 BALCH RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-8343
Mailing Address - Country:US
Mailing Address - Phone:256-319-3256
Mailing Address - Fax:
Practice Address - Street 1:1041 BALCH RD
Practice Address - Street 2:SUITE 180
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8343
Practice Address - Country:US
Practice Address - Phone:256-319-3256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5928122300000X, 1223P0700X
AL233720-00126900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist
No126900000XDental ProvidersDental Laboratory Technician