Provider Demographics
NPI:1790772788
Name:WOLFSON, FRANK L (DDS)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:L
Last Name:WOLFSON
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 1:11775 W 112TH ST
Mailing Address - Street 2:STE 204
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2761
Mailing Address - Country:US
Mailing Address - Phone:913-469-5444
Mailing Address - Fax:913-491-4477
Practice Address - Street 1:11775 W 112TH ST
Practice Address - Street 2:STE 204
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2761
Practice Address - Country:US
Practice Address - Phone:913-469-5444
Practice Address - Fax:913-491-4477
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice