Wolf Family Dentistry, PC.
Dentist, General Practice in La Porte, IN. Organization (NPI-2).
NPI number1174656342
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1174656342
- Entity type
- Organization (NPI-2)
- Legal business name
- Wolf Family Dentistry, PC.
- Organization subpart
- No
- Enumeration date
- Mar 14, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 12008861 | IN | Yes |
Practice location
3550 W Johnson RdLa Porte, IN 46350-8576
Phone 219-362-3730 · Fax 219-324-4273
Mailing address
3550 W Johnson RdLa Porte, IN 46350-8576
Phone 219-362-3730 · Fax 219-324-4273
Authorized official
Renee Ostermiller Wolf
Dentist
2193623730
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