MEDICARE: DR. BRANDON WOLF 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	DN28661.	FL
2	122300000X	Dentist	DN28661	FL
3	122300000X	Dentist	DS039738	PA
4	122300000X	Dentist	D.007302-C	AL
5	122300000X	Dentist	8352	SC

General Provider Information

NPI Number	:	1730597709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDON WOLF D.M.D

Provider Business Mailing Address
First Line	:	2817 ROCK MERRITT AVE
Second Line	:	WOMACK ARMY MEDICAL CENTER
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:

Provider Business Practice Location Address
First Line	:	16506 POINTE VILLAGE DR.
Second Line	:	SUITE 101
City	:	TAMPA
State	:	FL
Zip	:	33647
Country	:	US
Telephone Number	:	813-906-5668
Fax Number	:

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

Provider Enumeration Date	:	07/23/2014
Last Update Date	:	03/12/2026

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