Provider Demographics
NPI:1982965307
Name:WOLF, CHRISTOPHER LEON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LEON
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 1:7532 GRINDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20732-4121
Mailing Address - Country:US
Mailing Address - Phone:410-353-7840
Mailing Address - Fax:
Practice Address - Street 1:9120 CHESAPEAKE AVE # 301
Practice Address - Street 2:
Practice Address - City:NORTH BEACH
Practice Address - State:MD
Practice Address - Zip Code:20714-5017
Practice Address - Country:US
Practice Address - Phone:443-550-8115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD149981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice