Healthcare Provider Details

I. General information

NPI: 1891189759
Provider Name (Legal Business Name): ANDREW D WELLES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8055 MEADOW ROCK DR
WESTON WI
54476-5233
US

IV. Provider business mailing address

8055 MEADOW ROCK DR
WESTON WI
54476-5233
US

V. Phone/Fax

Practice location:
  • Phone: 715-241-6800
  • Fax:
Mailing address:
  • Phone: 715-574-2477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1001099-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: