Healthcare Provider Details

I. General information

NPI: 1275496333
Provider Name (Legal Business Name): WYOMING FAMILY DENTISTRY, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HANDLEY ST
PERRY NY
14530-1342
US

IV. Provider business mailing address

3 HANDLEY ST
PERRY NY
14530-1342
US

V. Phone/Fax

Practice location:
  • Phone: 585-237-3314
  • Fax: 585-237-2228
Mailing address:
  • Phone: 585-237-3314
  • Fax: 585-237-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: RONALD J WOLFF
Title or Position: DDS
Credential:
Phone: 585-237-3314