Individual
LARRY MILLER WOLFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3409 WORTH ST, #400, DALLAS, TX 75246
(214) 828-9115
(214) 828-1714
Mailing address
3409 WORTH ST, #400, DALLAS, TX 75246
(214) 828-9115
(214) 828-1714
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9712
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00P647
BLUE CROSS BS
—
Enumeration date
10/16/2006
Last updated
07/08/2007
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