Provider Demographics
NPI:1134199656
Name:WOLF, CANDACE E (DDS)
Entity type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:E
Last Name:WOLF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 N MESA
Mailing Address - Street 2:#D
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932
Mailing Address - Country:US
Mailing Address - Phone:915-833-3232
Mailing Address - Fax:915-833-3283
Practice Address - Street 1:8001 N MESA
Practice Address - Street 2:#D
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932
Practice Address - Country:US
Practice Address - Phone:915-833-3232
Practice Address - Fax:915-833-3283
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist