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General NPI Number Information
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NPI Number | 1174707350
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Entity Type | Organization
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Legal Business Name | DR. R. DEAN WELLS, INC.
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 900 N BECHTLE AVE
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City | SPRINGFIELD
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State | OH
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Zip | 45504-2082
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Country | US
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Telephone | 937-324-5523
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Fax |
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Provider Business Mailing Address
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Address Line | 900 NORTH BECHTLE AVENUE
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City | SPRINGFIELD
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State | OH
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Zip | 45504
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Country | US
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Telephone | 937-324-5523
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. R. DEAN WELLS
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Credential | OD
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Telephone | 937-324-5523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OH 2805
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License Number State | OH
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