Provider Demographics
NPI:1255957742
Name:WOLFE, EMILY (DMD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3528 ASHFORD DUNWOODY RD NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-2002
Mailing Address - Country:US
Mailing Address - Phone:770-455-6602
Mailing Address - Fax:
Practice Address - Street 1:3528 ASHFORD DUNWOODY RD NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-2002
Practice Address - Country:US
Practice Address - Phone:770-455-6602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0161221223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice