Organization
GREAT GRINS CHILDREN'S DENTISTRY, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA MICHELE WOLFMAN DDS (DOCTOR/OWNER)
(520) 325-4746
Entity
Organization
Contact information
Practice address
3953 E PARADISE FALLS DR, SUITE 110, TUCSON, AZ 85712-6688
(520) 325-4746
(520) 319-1031
Mailing address
3953 E PARADISE FALLS DR, SUITE 110, TUCSON, AZ 85712-6688
(520) 325-4746
(520) 319-1031
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6632
AZ
1223P0221X
Pediatric Dentistry
6742
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
967177
—
AZ
05
—
977473
—
AZ
Enumeration date
01/09/2012
Last updated
05/14/2013
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