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General NPI Number Information
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NPI Number | 1003683210
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Entity Type | Organization
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Legal Business Name | JOSHUA WOLF DDS PC
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Dates
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Enumeration Date | 12/07/2023
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 1229 BROADWAY STE 207
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City | HEWLETT
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State | NY
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Zip | 11557-2014
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Country | US
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Telephone | 516-374-2830
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Fax | 845-512-7023
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Provider Business Mailing Address
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Address Line | 1229 BROADWAY STE 207
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City | HEWLETT
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State | NY
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Zip | 11557-2014
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Country | US
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Telephone | 516-374-2830
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Fax |
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | ARACELY D RIVERA
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Credential |
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Telephone | 845-880-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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