Provider Demographics
NPI:1972654622
Name:WOLFE, JAMES T (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:WOLFE
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 1:16439 STONY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-8071
Mailing Address - Country:US
Mailing Address - Phone:317-773-7944
Mailing Address - Fax:
Practice Address - Street 1:2705 S BERKLEY RD
Practice Address - Street 2:STE 4A
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-8025
Practice Address - Country:US
Practice Address - Phone:765-453-2619
Practice Address - Fax:765-453-5076
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009605A1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics