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General NPI Number Information
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NPI Number | 1992954382
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Entity Type | Organization
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Legal Business Name | JOSEPH C. WIGFIELD, D.D.S., LLC
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 09/10/2008
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Provider Practice Location Address
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Address Line | 5371 STATE ROUTE 183 NE
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City | MAGNOLIA
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State | OH
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Zip | 44643
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Country | US
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Telephone | 330-866-5555
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Fax | 330-866-1800
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Provider Business Mailing Address
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Address Line | 5371 STATE ROUTE 183 N.E.
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City | MAGNOLIA
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State | OH
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Zip | 44643
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Country | US
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Telephone | 330-866-5555
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Fax | 330-866-1800
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JOSEPH C WIGFIELD
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Credential | D.D.S.
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Telephone | 330-866-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30021486
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License Number State | OH
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