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General NPI Number Information
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NPI Number | 1801896923
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Entity Type | Organization
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Legal Business Name | STEVEN WOLF, DDS, PC
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 25916 DEQUINDRE RD
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City | WARREN
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State | MI
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Zip | 48091-6112
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Country | US
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Telephone | 586-755-2770
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Fax | 586-755-1690
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Provider Business Mailing Address
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Address Line | 25916 DEQUINDRE RD
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City | WARREN
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State | MI
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Zip | 48091-6112
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Country | US
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Telephone | 586-755-2770
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Fax | 586-755-1690
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN MICHAEL WOLF
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Credential | DDS
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Telephone | 586-755-2770
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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 | 2901009207
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License Number State | MI
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