Individual
DR. THEODORE S WOHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
1680 E 19TH ST, BROOKLYN, NY 11229-1312
(718) 336-7190
(718) 645-2024
Mailing address
86 PROSPECT PARK SW, BROOKLYN, NY 11218-1205
(718) 832-4646
(718) 832-6660
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
046387
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01657987
—
NY
Enumeration date
10/16/2006
Last updated
06/05/2013
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