Individual
DR. MARK E. WOHLFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PH D
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12009501A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100120750C
—
IN
Enumeration date
04/28/2006
Last updated
02/17/2016
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