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General NPI Number Information
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NPI Number | 1972654622
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Entity Type | Individual
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Provider Name | JAMES T WOLFE DDS
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 04/07/2014
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Provider Practice Location Address
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Address Line | 2705 S BERKLEY RD STE 4A
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City | KOKOMO
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State | IN
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Zip | 46902-8025
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Country | US
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Telephone | 765-453-2619
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Fax | 765-453-5076
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Provider Business Mailing Address
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Address Line | 16439 STONY RIDGE DR
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City | NOBLESVILLE
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State | IN
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Zip | 46060-8071
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Country | US
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Telephone | 317-773-7944
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 12009605A
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License Number State | IN
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