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General NPI Number Information
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NPI Number | 1992938674
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Entity Type | Individual
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Provider Name | WILLIAM CHAD WOLFF DDS
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Gender | Male
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Dates
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Enumeration Date | 08/28/2009
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 5550 EAST FRANKLIN ROAD
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City | NAMPA
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State | ID
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Zip | 83687-7910
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Country | US
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Telephone | 201-461-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 12346 W CARIBEE INLET DR
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City | STAR
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State | ID
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Zip | 83669-5682
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Country | US
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Telephone | 208-559-0608
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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 | D-4256
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License Number State | ID
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