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General NPI Number Information
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NPI Number | 1992015721
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Entity Type | Individual
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Provider Name | JOSEF MANFRED WOLLMANN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 109 S 6TH ST STE A
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City | ALAMO
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State | TX
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Zip | 78516-2541
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Country | US
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Telephone | 956-787-3317
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Fax |
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Provider Business Mailing Address
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Address Line | 109 S 6TH ST STE A
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City | ALAMO
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State | TX
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Zip | 78516-2541
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Country | US
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Telephone | 956-787-3317
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0026078
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License Number State | TX
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