Provider Demographics
NPI:1629094545
Name:DRS. WOLFE AND PENN, LTD.
Entity Type:Organization
Organization Name:DRS. WOLFE AND PENN, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY-TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:PENN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:540-772-2913
Mailing Address - Street 1:4495 STARKEY RD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0617
Mailing Address - Country:US
Mailing Address - Phone:540-772-2913
Mailing Address - Fax:
Practice Address - Street 1:4495 STARKEY RD.
Practice Address - Street 2:SUITE A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0617
Practice Address - Country:US
Practice Address - Phone:540-772-2913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty