Provider Demographics
NPI:1740301738
Name:WOLF, WENDELL JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:WENDELL
Middle Name:JOHN
Last Name:WOLF
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 1:3501 W CHESTER PIKE
Mailing Address - Street 2:SUITE 100-A
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3704
Mailing Address - Country:US
Mailing Address - Phone:610-356-2460
Mailing Address - Fax:
Practice Address - Street 1:3501 W CHESTER PIKE
Practice Address - Street 2:SUITE 100-A
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3704
Practice Address - Country:US
Practice Address - Phone:610-356-2460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015279L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice