National Provider Identifier
Edward Jon Woodworth, DDS
Edward Jon Woodworth, DDS is listed in the NPPES registry with a primary specialty of Dentist in Clarence, NY and a listed phone number of (716) 759-8306.
Profile Overview
- NPI
- 1558585521
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- April 12, 2007
- Last Updated
- July 08, 2007
Practice Location
- 10346 Main Street
- Clarence, NY 14031-1604
Phone: (716) 759-8306
Specialties
- Dentist (122300000X)
Full Record
- NPI
- 1558585521
- Entity Type
- Individual
- Last Name
- Woodworth
- First Name
- Edward
- Middle Name
- Jon
- Name Prefix
- Dr.
- Credential
- DDS
- Mailing Street Address
- 10346 Main Street
- Mailing City
- Clarence
- Mailing State
- NY
- Mailing ZIP Code
- 14031-1604
- Mailing Country
- US
- Mailing Phone
- (716) 759-8306
- Mailing Fax
- (716) 759-2114
- Practice Street Address
- 10346 Main Street
- Practice City
- Clarence
- Practice State
- NY
- Practice ZIP Code
- 14031-1604
- Practice Country
- US
- Practice Phone
- (716) 759-8306
- Practice Fax
- (716) 759-2114
- Enumeration Date
- April 12, 2007
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X)
- Other Identifiers
- 01350889 (NY), 4000538 (NY, Independent Health)