Provider Demographics
NPI:1154718963
Name:WOLFF, SAMANTHA P (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:P
Last Name:WOLFF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 GIBBSBORO RD
Mailing Address - Street 2:
Mailing Address - City:CLEMENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-4130
Mailing Address - Country:US
Mailing Address - Phone:856-783-3300
Mailing Address - Fax:
Practice Address - Street 1:250 GIBBSBORO RD
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-4130
Practice Address - Country:US
Practice Address - Phone:856-783-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058759122300000X
NJDI026273122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ39OtherDENTIST