| Wolfy Dental Group Llc | |
|
51 S Whittlesey Ave Wallingford CT 06492-4101 | |
| (203) 265-3139 | |
| (203) 265-5133 |
| Full Name | Wolfy Dental Group Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 51 S Whittlesey Ave, Wallingford, Connecticut |
| Authorized Official Name and Position | Sandra Vukovic (OWNER/DENTIST) |
| Authorized Official Contact | 2032653139 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wolfy Dental Group Llc 51 S Whittlesey Ave Wallingford CT 06492-4101 Ph: (203) 265-3139 | Wolfy Dental Group Llc 51 S Whittlesey Ave Wallingford CT 06492-4101 Ph: (203) 265-3139 |
| NPI Number | 1467997106 |
|---|---|
| Provider Enumeration Date | 01/04/2017 |
| Last Update Date | 01/05/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467997106 | NPI | - | NPPES |
| 1346658051 | Medicaid | CT | |
| 1962429399 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11226 (Connecticut) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 006306 (Connecticut) | Secondary |
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