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General NPI Number Information
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NPI Number | 1710808233
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Entity Type | Organization
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Legal Business Name | KASSIDY WOLFE, DMD, LLC
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 123 S GREEN RIVER RD
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City | EVANSVILLE
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State | IN
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Zip | 47715-7314
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Country | US
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Telephone | 812-476-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 11700 DIAMOND ISLAND RD
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City | WADESVILLE
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State | IN
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Zip | 47638-9108
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Country | US
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Telephone | 812-575-7204
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. KASSIDY SUGGS
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Credential | DMD
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Telephone | 812-575-7204
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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 |
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License Number State |
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