Individual
MR. MICHAEL G WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
668 NO GARDEN ST, TOOELE, UT 84074-1724
(435) 882-1381
(435) 833-0812
Mailing address
668 NO GARDEN ST, TOOELE, UT 84074-1724
(435) 882-1381
(435) 833-0812
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
142601
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
682342
UNITED CONCORDIA
—
Enumeration date
02/26/2007
Last updated
07/08/2007
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