Provider Demographics
NPI:1326268822
Name:WOLF, MARY-ANN ZANOUDAKIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY-ANN
Middle Name:ZANOUDAKIS
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 1:757 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1044
Mailing Address - Country:US
Mailing Address - Phone:330-922-0808
Mailing Address - Fax:330-922-5939
Practice Address - Street 1:757 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1044
Practice Address - Country:US
Practice Address - Phone:330-922-0808
Practice Address - Fax:330-922-5939
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18307122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist