Healthcare Provider Details

I. General information

NPI: 1043064918
Provider Name (Legal Business Name): CHRISTINA WOLFE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8850 COLUMBIA 100 PKWY STE 312
COLUMBIA MD
21045-2377
US

IV. Provider business mailing address

2714 SNOWMILL CT
ELLICOTT CITY MD
21043-1921
US

V. Phone/Fax

Practice location:
  • Phone: 512-516-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number8087
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: