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General NPI Number Information
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NPI Number | 1992826713
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Entity Type | Organization
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Legal Business Name | DR. JOHN W. WOLF DDS, PC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 212 W 15TH ST FL 1
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City | NEW YORK
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State | NY
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Zip | 10011-6501
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Country | US
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Telephone | 212-366-5900
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Fax | 212-366-6028
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Provider Business Mailing Address
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Address Line | 212 W 15TH ST FL 1
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City | NEW YORK
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State | NY
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Zip | 10011-6501
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Country | US
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Telephone | 212-366-5900
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Fax | 212-366-6028
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JOHN W. WOLF
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Credential | DDS
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Telephone | 212-366-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 038642
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License Number State | NY
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