Provider Demographics
NPI:1679635288
Name:WOLF, TERRANCE JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:JOSEPH
Last Name:WOLF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 HERMITAGE HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-5720
Mailing Address - Country:US
Mailing Address - Phone:330-692-8538
Mailing Address - Fax:
Practice Address - Street 1:1049 N HERMITAGE RD.
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3114
Practice Address - Country:US
Practice Address - Phone:724-342-1959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0370481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice