Provider Demographics
NPI:1477575777
Name:WOOLRIDGE-OFORI, THERESA (DDS)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:WOOLRIDGE-OFORI
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 1:1301 BERTHA HOWE AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-7502
Mailing Address - Country:US
Mailing Address - Phone:702-345-2299
Mailing Address - Fax:702-345-2303
Practice Address - Street 1:1301 BERTHA HOWE AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-7502
Practice Address - Country:US
Practice Address - Phone:702-345-2299
Practice Address - Fax:702-345-2303
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4669T1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice