Provider Demographics
NPI:1538208442
Name:WOLFF, GEORGE J (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:J
Last Name:WOLFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N SAN MATEO DR # 12
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2655
Mailing Address - Country:US
Mailing Address - Phone:650-347-7100
Mailing Address - Fax:650-347-1758
Practice Address - Street 1:255 N SAN MATEO DR STE 2
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2671
Practice Address - Country:US
Practice Address - Phone:650-347-7100
Practice Address - Fax:650-347-1758
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice