Provider Demographics
NPI:1972609501
Name:WOOLFORD, PATRICIA GAIL (DDS)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GAIL
Last Name:WOOLFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:GAIL
Other - Last Name:HAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:519 E FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-5337
Mailing Address - Country:US
Mailing Address - Phone:580-772-7747
Mailing Address - Fax:580-772-7750
Practice Address - Street 1:612 NW 25TH ST
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76164
Practice Address - Country:US
Practice Address - Phone:817-625-4311
Practice Address - Fax:580-772-7750
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK57351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice