Individual
DR. RANDLE LEE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1332 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-6427
(706) 869-1818
Mailing address
1332 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-6427
(706) 869-1818
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4892
AL
122300000X
Dentist
Primary
DN 014063
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278159
—
OR
05
—
529925330
—
AL
Enumeration date
07/19/2006
Last updated
08/04/2010
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