Individual
STACEY WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
7975 L ST, SUITE A, OMAHA, NE 68127-1731
(402) 339-3187
(402) 339-3914
Mailing address
7975 L STREET, SUITE A, OMAHA, NE 68127
(402) 339-3187
(402) 339-3914
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1587
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025450000
—
NE
Enumeration date
01/30/2009
Last updated
01/30/2009
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