Provider Demographics
NPI:1679577928
Name:WOLFF, RICHARD HOWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HOWARD
Last Name:WOLFF
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 1:110 BRICK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-2036
Mailing Address - Country:US
Mailing Address - Phone:845-354-8855
Mailing Address - Fax:
Practice Address - Street 1:110 BRICK CHURCH RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-2036
Practice Address - Country:US
Practice Address - Phone:845-354-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0303091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice