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General NPI Number Information
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NPI Number | 1700932753
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Entity Type | Individual
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Provider Name | KEVIN WOLFF DMD
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23844 S POWER RD STE 106
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City | QUEEN CREEK
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State | AZ
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Zip | 85242-6152
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Country | US
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Telephone | 480-663-9191
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Fax | 480-663-9197
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Provider Business Mailing Address
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Address Line | 17944 E. AVENIDA DEL VALLE DR.
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City | GILBERT
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State | AZ
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Zip | 85297
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Country | US
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Telephone | 480-988-3189
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3937
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License Number State | AZ
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