Individual
DR. JEREMY MANTLE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
(907) 377-6767
Mailing address
1615 TRUEMPER ST, JBSA LACKLAND, TX 78236-5511
(210) 292-0123
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12590570-9926
UT
Other
Enumeration date
08/02/2016
Last updated
07/29/2024
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