Provider Demographics
NPI:1003370750
Name:WOHLGEMUTH, PIERRE LOUIS AUGUSTE (DDS)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:LOUIS AUGUSTE
Last Name:WOHLGEMUTH
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 1:4545 CENTER BLVD APT 2002
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5940
Mailing Address - Country:US
Mailing Address - Phone:646-535-3380
Mailing Address - Fax:
Practice Address - Street 1:222 E 41ST ST FL 22
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6739
Practice Address - Country:US
Practice Address - Phone:212-263-7552
Practice Address - Fax:212-263-6931
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAD.00005211223E0200X
VA04014173961223E0200X
TX372371223E0200X
NY0001191223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics