MEDICARE: DR. WILLIAM H WOLFERSBERGER DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	030065	NY

General Provider Information

NPI Number	:	1194867010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM H WOLFERSBERGER DMD

Provider Business Mailing Address
First Line	:	655 76TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3325
Country	:	US
Telephone Number	:	718-748-5765
Fax Number	:	718-748-5730

Provider Business Practice Location Address
First Line	:	655 76TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3325
Country	:	US
Telephone Number	:	718-748-5765
Fax Number	:	718-748-5730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	09/06/2007

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