Individual
MR. STAN C WOLKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4770 CAPITOLA RD, CAPITOLA, CA 95010
(650) 704-5991
Mailing address
4770 CAPITOLA RD, CAPITOLA, CA 95010
(650) 704-5991
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
AW5527861
CA
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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