Individual
MS. LESLIE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
203 PINE STREET WEST, NEW AUGUSTA, MS 39462-0411
(601) 964-8400
(601) 964-8404
Mailing address
PO BOX 411, NEW AUGUSTA, MS 39462-0411
(601) 964-8400
(601) 964-8404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3432-07
MS
Other
Enumeration date
01/28/2008
Last updated
10/01/2009
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