Healthcare Provider Details

I. General information

NPI: 1548551013
Provider Name (Legal Business Name): NELSON & WELLS ORAL AND MAXILLOFACIAL SURGERY PROF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 02/22/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6850 E HAMPDEN AVE SUITE 202
DENVER CO
80224-3024
US

IV. Provider business mailing address

6850 E HAMPDEN AVE SUITE 202
DENVER CO
80224-3024
US

V. Phone/Fax

Practice location:
  • Phone: 303-758-6850
  • Fax: 303-758-0729
Mailing address:
  • Phone: 303-758-6850
  • Fax: 303-758-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberCO6819
License Number StateCO

VIII. Authorized Official

Name: DR. ZACHARY TYLER WELLS
Title or Position: PARTNER
Credential: DMD
Phone: 303-758-6850