Organization
WOLFY DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA VUKOVIC DDS (OWNER/DENTIST)
(203) 265-3139
Entity
Organization
Contact information
Practice address
51 S WHITTLESEY AVE, WALLINGFORD, CT 06492-4101
(203) 265-3139
(203) 265-5133
Mailing address
51 S WHITTLESEY AVE, WALLINGFORD, CT 06492-4101
(203) 265-3139
(203) 265-5133
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11226
CT
1223P0221X
Pediatric Dentistry
006306
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346658051
—
CT
05
—
1962429399
—
CT
Enumeration date
01/04/2017
Last updated
01/05/2017
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