MEDICARE: DR. COREY J WELLS DMD

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	122300000X	Dentist	4417	NH
2	1223G0001X	General Practice Dentistry	4417	NH

General Provider Information

NPI Number	:	1033602925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COREY J WELLS DMD

Provider Business Mailing Address
First Line	:	PO BOX 7
Second Line	:
City	:	LANCASTER
State	:	NH
Zip	:	03584-0007
Country	:	US
Telephone Number	:	603-788-2517
Fax Number	:	603-788-2520

Provider Business Practice Location Address
First Line	:	22 BUNKER HILL ST
Second Line	:
City	:	LANCASTER
State	:	NH
Zip	:	03584-3009
Country	:	US
Telephone Number	:	603-788-2517
Fax Number	:	603-788-2520

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

Provider Enumeration Date	:	06/14/2018
Last Update Date	:	07/27/2023

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