Provider Demographics
NPI:1912172586
Name:WOLF, KAREN KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:KAY
Last Name:WOLF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:203 20TH ST NW
Mailing Address - Street 2:WILLOW LAWN MALL
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2017
Mailing Address - Country:US
Mailing Address - Phone:319-352-4784
Mailing Address - Fax:319-352-4782
Practice Address - Street 1:203 20TH ST NW
Practice Address - Street 2:WILLOW LAWN MALL
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2017
Practice Address - Country:US
Practice Address - Phone:319-352-4784
Practice Address - Fax:319-352-4782
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079451223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics