Provider Demographics
NPI:1548420045
Name:JOSEPH J WAFF III DDS PC
Entity Type:Organization
Organization Name:JOSEPH J WAFF III DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JUDSON
Authorized Official - Last Name:WAFF
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-293-9916
Mailing Address - Street 1:2202 NORTH BERKSHIRE RD
Mailing Address - Street 2:#103
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2794
Mailing Address - Country:US
Mailing Address - Phone:434-293-9916
Mailing Address - Fax:434-293-3879
Practice Address - Street 1:2202 NORTH BERKSHIRE RD
Practice Address - Street 2:#103
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2794
Practice Address - Country:US
Practice Address - Phone:434-293-9916
Practice Address - Fax:434-293-3879
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPH J WAFF III DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty