Healthcare Provider Details

I. General information

NPI: 1659586881
Provider Name (Legal Business Name): WILLIAM WOLFSON,D.M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 02/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 MORRIS PARK AVE
BRONX NY
10462-3715
US

IV. Provider business mailing address

960 MORRIS PARK AVE
BRONX NY
10462-3715
US

V. Phone/Fax

Practice location:
  • Phone: 718-863-5077
  • Fax: 718-863-7921
Mailing address:
  • Phone: 718-863-5077
  • Fax: 718-863-7921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM WOLFSON
Title or Position: PRES.
Credential: D.M.D.
Phone: 17188635077