MEDICARE: DR. LOREN B WELLS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8159	NC

General Provider Information

NPI Number	:	1952500290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOREN B WELLS DDS

Provider Business Mailing Address
First Line	:	8450 LOUISBURG RD
Second Line	:	SUITE 130
City	:	RALEIGH
State	:	NC
Zip	:	27616-8006
Country	:	US
Telephone Number	:	919-360-0097
Fax Number	:	919-435-7371

Provider Business Practice Location Address
First Line	:	8450 LOUISBURG RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-7515
Country	:	US
Telephone Number	:	919-266-5332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	03/31/2008

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