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NPI Code Detail

MEDICARE: WALTER J. WULF, DDS, P.A.

MEDICARE: WALTER J. WULF, DDS, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6107NC

General Provider Information

NPI Number : 1184762049
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALTER J. WULF, DDS, P.A.
Provider Business Mailing Address
First Line : 2253 CAROLINA BEACH RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7237
Country : US
Telephone Number : 910-343-0830
Fax Number :
Provider Business Practice Location Address
First Line : 2253 CAROLINA BEACH RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7237
Country : US
Telephone Number : 910-343-0830
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. WALTER J. WULF
Credential : DDS
Telephone Number : 910-343-0830
Provider Enumeration Date : 02/02/2007
Last Update Date : 08/22/2020

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