Provider Demographics
NPI:1598493348
Name:WOLFE DENTAL PLLC
Entity type:Organization
Organization Name:WOLFE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:802-885-2205
Mailing Address - Street 1:109 SUMMER ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-3538
Mailing Address - Country:US
Mailing Address - Phone:802-885-2205
Mailing Address - Fax:
Practice Address - Street 1:109 SUMMER ST STE 4
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-3538
Practice Address - Country:US
Practice Address - Phone:802-885-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental