Provider Demographics
NPI:1457569287
Name:M.J. WOLFF, DMD, PA
Entity Type:Organization
Organization Name:M.J. WOLFF, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISANDE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-686-8580
Mailing Address - Street 1:1501 PRESIDENTIAL WAY
Mailing Address - Street 2:SUITE #14
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1800
Mailing Address - Country:US
Mailing Address - Phone:561-686-8580
Mailing Address - Fax:561-689-7287
Practice Address - Street 1:1501 PRESIDENTIAL WAY
Practice Address - Street 2:SUITE #14
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1800
Practice Address - Country:US
Practice Address - Phone:561-686-8580
Practice Address - Fax:561-689-7287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16477122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty