Organization
CHRISTOPHER R WELLS DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER R WELLS DMD (OWNER/PRESIDENT)
(208) 345-2771
Entity
Organization
Contact information
Practice address
1880 JUDITH LN STE 210, BOISE, ID 83705-3185
(208) 345-2771
(208) 345-2888
Mailing address
1880 JUDITH LN STE 210, BOISE, ID 83705-3185
(208) 345-2771
(208) 345-2888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-3568
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1347936
UNITED CONCORDIA
ID
01
—
6J432
BLUE CROSS OF IDAHO
ID
05
—
806186200
—
ID
01
—
ID03568A
DELTA DENTAL
ID
Enumeration date
07/13/2006
Last updated
12/20/2008
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