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General NPI Number Information
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NPI Number | 1881868842
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Entity Type | Organization
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Legal Business Name | STANLEYJWOLFEDDSPC
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Dates
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Enumeration Date | 04/21/2008
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Last Update Date | 04/21/2008
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Provider Practice Location Address
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Address Line | 385 MAIN ST SUITE4
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City | WEST HAVEN
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State | CT
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Zip | 06516-4312
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Country | US
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Telephone | 203-933-3131
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Fax | 203-934-4938
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Provider Business Mailing Address
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Address Line | 385 MAIN ST SUITE4
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City | WEST HAVEN
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State | CT
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Zip | 06516-4312
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Country | US
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Telephone | 203-933-3131
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Fax | 203-934-4938
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STANLEY J WOLFE
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Credential | DDS
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Telephone | 203-933-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 3949
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License Number State | CT
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