Provider Demographics
NPI:1558477992
Name:WOLF, JAMES B (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:WOLF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:45 EAST WASHINGTON ST
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-3034
Mailing Address - Country:US
Mailing Address - Phone:440-247-8641
Mailing Address - Fax:440-247-5448
Practice Address - Street 1:45 EAST WASHINGTON ST
Practice Address - Street 2:STE 301
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-3034
Practice Address - Country:US
Practice Address - Phone:440-247-8641
Practice Address - Fax:440-247-5448
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice