Healthcare Provider Details

I. General information

NPI: 1457983157
Provider Name (Legal Business Name): CATHERINE MARIE WROCLAWSKI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 WOODPORT RD
SPARTA NJ
07871-2633
US

IV. Provider business mailing address

171 WOODPORT RD
SPARTA NJ
07871-2633
US

V. Phone/Fax

Practice location:
  • Phone: 973-729-7979
  • Fax:
Mailing address:
  • Phone: 973-729-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22DI02873600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS044664
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number07668
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD14480
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number77538
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN25815
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: