Provider Demographics
NPI:1073543476
Name:WOLL, MARGO YELLIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARGO
Middle Name:YELLIN
Last Name:WOLL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 WOODVIEW LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-3573
Mailing Address - Country:US
Mailing Address - Phone:248-626-0459
Mailing Address - Fax:
Practice Address - Street 1:25882 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-9822
Practice Address - Country:US
Practice Address - Phone:888-833-8441
Practice Address - Fax:888-330-4331
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901011880122300000X
NY052549122300000X
PADS036752122300000X
MA21530122300000X
CT009567122300000X
DCDEN1000521122300000X
RIDEN02922122300000X
VT016-0002216122300000X
NJDI02315900122300000X
NH03530122300000X
MD13642122300000X
KS60412122300000X
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3413200Medicaid