Organization
STEVEN WOLF, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN MICHAEL WOLF DDS (PRESIDENT)
(586) 755-2770
Entity
Organization
Contact information
Practice address
25916 DEQUINDRE RD, WARREN, MI 48091-6112
(586) 755-2770
(586) 755-1690
Mailing address
25916 DEQUINDRE RD, WARREN, MI 48091-6112
(586) 755-2770
(586) 755-1690
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901009207
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107503
CARE CHOICES
MI
01
—
147805
GREAT LAKES HEALTH PLAN
MI
01
—
4139520
AETNA
—
01
—
47679
OMNICARE
MI
01
—
664
GREAT LAKE HEALTH PLAN
MI
01
—
9755066630
BCBS
MI
01
—
RJ017024
BCBS
MI
01
—
SW009207
BCBS LICENSE
MI
01
—
T82976
HAP
MI
01
—
U93813
HAP
MI
Enumeration date
07/29/2005
Last updated
04/08/2008
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