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General NPI Number Information
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NPI Number | 1316386576
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Entity Type | Organization
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Legal Business Name | JENNIFER L WELLS DDS PA
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 814 SLOOP AVE
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City | KANNAPOLIS
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State | NC
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Zip | 28083-2992
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Country | US
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Telephone | 704-933-2115
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Fax | 704-932-2053
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Provider Business Mailing Address
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Address Line | 814 SLOOP AVE
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City | KANNAPOLIS
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State | NC
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Zip | 28083-2992
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Country | US
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Telephone | 704-933-2115
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Fax | 704-932-2053
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENNIFER LYNN WELLS
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Credential | D.D.S.
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Telephone | 704-933-2115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9538
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License Number State | NC
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