Provider Demographics
NPI:1386481034
Name:WOODRUFF, TRENT JAMES
Entity type:Individual
Prefix:DR
First Name:TRENT
Middle Name:JAMES
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 CHANCELLOR DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-3902
Mailing Address - Country:US
Mailing Address - Phone:570-908-9693
Mailing Address - Fax:
Practice Address - Street 1:750 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2198
Practice Address - Country:US
Practice Address - Phone:717-762-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0446851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice