Individual
DR. JACK EDWIN WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
139 LONG RD, CHESTERFIELD, MO 63005-1223
(636) 530-7260
(636) 733-9084
Mailing address
139 LONG RD, CHESTERFIELD, MO 63005-1223
(636) 530-7260
(636) 733-9084
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN14616
MO
Other
Enumeration date
12/18/2006
Last updated
08/21/2019
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