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Individual

RICHARD EVAN WOLFERT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1121 MAIN ST, SUITE #2, SOUTH WEYMOUTH, MA 02190-1513
(781) 335-0604
Mailing address
9 DALEY RD, HINGHAM, MA 02043-1201
(781) 749-4151

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14972
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
014972
DELTA PROVIDER NUMBER
MA
Enumeration date
11/22/2005
Last updated
07/08/2007
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