MEDICARE: DR. CHRISTOPHER LEON WOLF D.D.S.

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	1223G0001X	General Practice Dentistry	14998	MD

General Provider Information

NPI Number	:	1982965307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER LEON WOLF D.D.S.

Provider Business Mailing Address
First Line	:	7532 GRINDSTONE CT
Second Line	:
City	:	CHESAPEAKE BEACH
State	:	MD
Zip	:	20732-4121
Country	:	US
Telephone Number	:	410-353-7840
Fax Number	:

Provider Business Practice Location Address
First Line	:	9120 CHESAPEAKE AVE # 301
Second Line	:
City	:	NORTH BEACH
State	:	MD
Zip	:	20714-5017
Country	:	US
Telephone Number	:	443-550-8115
Fax Number	:

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

Provider Enumeration Date	:	06/01/2012
Last Update Date	:	05/27/2015

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