Provider Demographics
NPI:1982095808
Name:CINDY WOLT DDS INC
Entity Type:Organization
Organization Name:CINDY WOLT DDS INC
Other - Org Name:ELEMENTS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-966-0011
Mailing Address - Street 1:848 WEST COSHOCTON STREET
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031
Mailing Address - Country:US
Mailing Address - Phone:740-966-0011
Mailing Address - Fax:740-966-5556
Practice Address - Street 1:848 WEST COSHOCTON STREET
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43031
Practice Address - Country:US
Practice Address - Phone:740-966-0011
Practice Address - Fax:740-966-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH122300000X, 1223S0112X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty