Provider Demographics
NPI:1316256902
Name:WOOFF, CORY GENE (DMD)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:GENE
Last Name:WOOFF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4127 W MENADOTA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7415
Mailing Address - Country:US
Mailing Address - Phone:979-571-0847
Mailing Address - Fax:
Practice Address - Street 1:781 S COTTON LN
Practice Address - Street 2:SUITE 100
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-4643
Practice Address - Country:US
Practice Address - Phone:623-882-3636
Practice Address - Fax:623-932-9041
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ82281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice