Organization
DODI R. WOOLLEY DDS, INC
Active
Other names
Smile Your Best Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DODI R. WOOLLEY DDS (DENTIST)
(219) 987-5733
Entity
Organization
Contact information
Practice address
534 N HALLOCK ST, DEMOTTE, IN 46310
(219) 987-5733
(219) 987-6162
Mailing address
PO BOX 848, DEMOTTE, IN 46310
(219) 987-5733
(219) 987-6162
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6974
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
431657
UNITED CONCORDIA
—
Enumeration date
05/03/2007
Last updated
01/04/2016
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