Individual
DR. TIMOTHY RAND WOLFENDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
65 JAMES ST, SUITE 204, WORCESTER, MA 01603-1026
(508) 753-8778
Mailing address
14 DUVAL RD., DUDLEY, MA 01507-6820
(508) 765-2821
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MA16775
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0269697
—
MA
Enumeration date
01/30/2007
Last updated
07/08/2007
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