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NPI Code Detail

MEDICARE: ROBERT H. WOOLF, DDS, PC

MEDICARE: ROBERT H. WOOLF, DDS, PC
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
11223P0300XPeriodonticsD5235OR

General Provider Information

NPI Number : 1629095526
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT H. WOOLF, DDS, PC
Provider Business Mailing Address
First Line : 320 A AVE
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97034-3056
Country : US
Telephone Number : 503-635-3584
Fax Number : 503-635-6813
Provider Business Practice Location Address
First Line : 320 A AVE
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97034-3056
Country : US
Telephone Number : 503-635-3584
Fax Number : 503-635-6813
Authorized Official
Title or Position : OWNER
Name : ROBERT H WOOLF
Credential : DDS
Telephone Number : 503-635-3584
Provider Enumeration Date : 07/16/2006
Last Update Date : 08/22/2020

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