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Susan Earnestine Wofford, D.M.D

Dentist in Louisville, KY. Individual provider (NPI-1).

NPI number1114309986
StatusActive
Last updated in NPPESNov 3, 2022

Details

NPI
1114309986
Entity type
Individual (NPI-1)
Name
Mrs. Susan Earnestine Wofford
Credential
D.M.D
Sex
Female
Sole proprietor
No
Enumeration date
Jun 29, 2015
Certification date
Nov 3, 2022
Last updated
Nov 3, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist9716KYYes
122300000X Dentist12013505AIN

Other names

  • Susan Wofford Himschoot (Former Name)

Practice location

415 Benjamin Ln
Louisville, KY 40222-5813

Phone 502-423-7868

Mailing address

2241 State Street
Suite C
New Albany, IN 47150

Phone 812-945-5100 · Fax 502-459-4226

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