| Stanleyjwolfeddspc | |
|
385 Main St Suite4 West Haven CT 06516-4312 | |
| (203) 933-3131 | |
| (203) 934-4938 |
| Full Name | Stanleyjwolfeddspc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 385 Main St, West Haven, Connecticut |
| Authorized Official Name and Position | Stanley J Wolfe (PRESIDENT) |
| Authorized Official Contact | 2039333131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanleyjwolfeddspc 385 Main St Suite4 West Haven CT 06516-4312 Ph: (203) 933-3131 | Stanleyjwolfeddspc 385 Main St Suite4 West Haven CT 06516-4312 Ph: (203) 933-3131 |
| NPI Number | 1881868842 |
|---|---|
| Provider Enumeration Date | 04/21/2008 |
| Last Update Date | 04/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881868842 | NPI | - | NPPES |
| 002039493 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3949 (Connecticut) | Primary |
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