Individual
DR. WAVEL LOU WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4417 W GORE BLVD STE 11, LAWTON, OK 73505-5978
(580) 248-8418
(580) 248-4118
Mailing address
4417 W GORE BLVD, SUITE 11, LAWTON, OK 73505-5978
(580) 248-8418
(580) 248-4118
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3494
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100194430A
—
OK
Enumeration date
09/21/2006
Last updated
05/16/2016
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