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General NPI Number Information
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NPI Number | 1912057050
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Entity Type | Organization
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Legal Business Name | WOODFIN ORTHODONTICS, P.A.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 4857 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32503-2446
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Country | US
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Telephone | 850-477-2180
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Fax | 850-484-6447
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Provider Business Mailing Address
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Address Line | 4857 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32503-2446
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Country | US
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Telephone | 850-477-2180
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Fax | 850-484-6447
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREGORY K WOODFIN
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Credential | D.M.D.
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Telephone | 850-477-2180
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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 | DN0009780
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License Number State | FL
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