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General NPI Number Information
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NPI Number | 1629094545
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Entity Type | Organization
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Legal Business Name | DRS. WOLFE AND PENN, LTD.
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4495 STARKEY RD. SUITE A
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City | ROANOKE
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State | VA
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Zip | 24018-0617
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Country | US
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Telephone | 540-772-2913
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Fax |
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Provider Business Mailing Address
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Address Line | 4495 STARKEY RD. SUITE A
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City | ROANOKE
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State | VA
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Zip | 24018-0617
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Country | US
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Telephone | 540-772-2913
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Fax |
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Authorized Official
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Title or Position | SECRETARY-TREASURER
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Name | DR. JOSEPH H. PENN
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Credential | D.M.D.
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Telephone | 540-772-2913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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