Individual
MARIANNE WOLFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1530 BROADWAY, OAKLAND, CA 94612-2002
(510) 251-8006
Mailing address
105 WESTCHESTER ST, MORAGA, CA 94556-1756
(925) 377-1297
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
34592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D34592
DENTICAL PROVIDER #
CA
Enumeration date
01/02/2007
Last updated
07/08/2007
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