Woodruff, Jon Michael

Woodruff, Jon Michael is an individual health care provider with primary practice located at 861 E Allegheny Ave , Philadelphia PA 19134-2401. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Woodruff, Jon Michael can be contacted via phone (215) 302-3156.

Contact Information

Primary practice address
861 E Allegheny Ave Philadelphia PA 19134-2401
Phone: (215) 302-3156
Fax: (215) 329-2369
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 6814 Kansas
Dental Providers / Dentist 122300000X DS044372 Pennsylvania

Profile Details

NPI number 1366435331
LBN Legal business name Woodruff, Jon Michael
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2005
Last updated Apr 24th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366435331 NPPES
Kansas Other 017363 BLUE CROSS BLUE SHIELD
Kansas MEDICAID 100225410-B BLUE CROSS BLUE SHIELD
Kansas Other 000781486 BLUE CROSS BLUE SHIELD

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