MEDICARE: DR. AARON MICHAEL WULFF D.M.D.

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
1	122300000X	Dentist	8769	KY
2	122300000X	Dentist	D8741	AZ

General Provider Information

NPI Number	:	1447486253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON MICHAEL WULFF D.M.D.

Provider Business Mailing Address
First Line	:	3140 STILLWATER DR STE B
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86305-7105
Country	:	US
Telephone Number	:	928-445-3181
Fax Number	:

Provider Business Practice Location Address
First Line	:	3140 STILLWATER DR STE B
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86305-7105
Country	:	US
Telephone Number	:	928-445-3181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	01/20/2021

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