# WELLSPACE PRIMARY CARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104647817
- **Authorized official:** DR. MICHAEL DAVID DICK DO (FAMILY MEDICINE PHYSICIAN)
- **Authorized official phone:** (714) 553-3887

## Contact information

- **Practice address:** 65 WALNUT ST STE 500, WELLESLEY, MA 02481-2112
- **Practice address phone:** (781) 304-8236
- **Mailing address:** 10 CUMBERLAND RD, BELMONT, MA 02478-2111
- **Mailing address phone:** (714) 553-3887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/24/2024
- **Last updated:** 02/13/2025