Individual
DR. GARY P. WELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS PA
Contact information
Practice address
825 MAJESTIC CT, STE. C, GASTONIA, NC 28054-5186
(704) 864-6721
(704) 864-1175
Mailing address
825 MAJESTIC CT, STE. C, GASTONIA, NC 28054-5186
(704) 864-6721
(704) 864-1175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NC4417
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8999096
—
NC
Enumeration date
11/12/2006
Last updated
07/08/2007
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