Provider Demographics
NPI:1487232658
Name:WELL DRESSED WIGS, INC.
Entity Type:Organization
Organization Name:WELL DRESSED WIGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHESIS PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-821-5684
Mailing Address - Street 1:6016 WHITSETT AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4536
Mailing Address - Country:US
Mailing Address - Phone:818-821-5684
Mailing Address - Fax:
Practice Address - Street 1:6016 WHITSETT AVE APT 9
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4536
Practice Address - Country:US
Practice Address - Phone:818-821-5684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment