Organization
J R WOLFENDEN DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY R WOLFENDEN DDS (PRESIDENT)
(608) 489-3499
Entity
Organization
Contact information
Practice address
925 WATER AVE, HILLSBORO, WI 54634
(608) 489-3499
Mailing address
PO BOX 31, HILLSBORO, WI 54634-0031
(608) 489-3499
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5001524015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33660600
—
WI
Enumeration date
04/06/2007
Last updated
08/22/2020
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