Provider Demographics
NPI:1164982187
Name:WOLF, JODI (DDS)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:WOLF
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 1:101 PROGRESS DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2563
Mailing Address - Country:US
Mailing Address - Phone:215-345-7373
Mailing Address - Fax:215-345-0242
Practice Address - Street 1:101 PROGRESS DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2563
Practice Address - Country:US
Practice Address - Phone:215-345-7373
Practice Address - Fax:215-345-0242
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0441631223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery