Provider Demographics
NPI:1003898115
Name:WOLFF, MICHAEL JOHN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:WOLFF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15223-2124
Mailing Address - Country:US
Mailing Address - Phone:412-784-0228
Mailing Address - Fax:412-784-0487
Practice Address - Street 1:369 BUTLER ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-2124
Practice Address - Country:US
Practice Address - Phone:412-784-0228
Practice Address - Fax:412-784-0487
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022932L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0858784OtherMEDICAL ASSISTANCE