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General NPI Number Information
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NPI Number | 1558668665
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Entity Type | Organization
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Legal Business Name | WILLIAM WOLFERSBERGER DMD PC
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 655 76TH ST
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City | BROOKLYN
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State | NY
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Zip | 11209-3325
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Country | US
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Telephone | 718-748-5765
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Fax | 718-748-5730
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Provider Business Mailing Address
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Address Line | 655 76TH ST
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City | BROOKLYN
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State | NY
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Zip | 11209-3325
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Country | US
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Telephone | 718-748-5765
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Fax | 718-748-5730
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DONNA BROWER
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Credential |
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Telephone | 718-748-5765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 030065
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License Number State | NY
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