Provider Demographics
NPI:1285332726
Name:BEN WOLFE DMD PC
Entity type:Organization
Organization Name:BEN WOLFE DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-844-6550
Mailing Address - Street 1:5025 NE ELAM YOUNG PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6405
Mailing Address - Country:US
Mailing Address - Phone:503-844-6550
Mailing Address - Fax:503-844-7121
Practice Address - Street 1:5025 NE ELAM YOUNG PKWY STE 150
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6405
Practice Address - Country:US
Practice Address - Phone:503-844-6550
Practice Address - Fax:503-844-7121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental