Healthcare Provider Details

I. General information

NPI: 1831547181
Provider Name (Legal Business Name): WAYNE RICHARD WOELLHAF DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8011 MERIDIAN PARK DR
FALCON CO
80831
US

IV. Provider business mailing address

8011 MERIDIAN PARK DR
FALCON CO
80831
US

V. Phone/Fax

Practice location:
  • Phone: 719-494-1100
  • Fax:
Mailing address:
  • Phone: 719-494-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number00204217
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: