Individual
DODI R WOOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
534 N HALLECK ST, DEMOTTE, IN 46310-9553
(219) 987-5733
Mailing address
534 N HALLECK ST, PO BOX 848, DEMOTTE, IN 46310-9553
(219) 987-5733
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009502
IN
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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