Organization
BWDENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HENRY WELLS JR. D.D.S. (PRESIDENT)
(918) 775-3201
Entity
Organization
Contact information
Practice address
200 E CHOCTAW AVE, SALLISAW, OK 74955-4604
(918) 775-3201
(918) 775-3394
Mailing address
200 E CHOCTAW AVE, PO BOX 625, SALLISAW, OK 74955-4604
(918) 775-3201
(918) 775-3394
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4740
OK
Other
Enumeration date
08/28/2006
Last updated
08/22/2020
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