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General NPI Number Information
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NPI Number | 1386867802
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Entity Type | Organization
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Legal Business Name | STEVE L WOLF DDS PC
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 23895 NOVI RD SUITE 200
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City | NOVI
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State | MI
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Zip | 48375-0201
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Country | US
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Telephone | 248-380-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 23895 NOVI RD SUITE 200
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City | NOVI
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State | MI
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Zip | 48375-0201
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Country | US
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Telephone | 248-380-8020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEVE L WOLF
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Credential | DDS
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Telephone | 248-380-8020
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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 | MI
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State | MI
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