Provider Demographics
NPI:1043340763
Name:WELLS, JAMES M (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:WELLS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 PROFESSIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4302
Mailing Address - Country:US
Mailing Address - Phone:252-247-3010
Mailing Address - Fax:252-247-3044
Practice Address - Street 1:208 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4302
Practice Address - Country:US
Practice Address - Phone:252-247-3010
Practice Address - Fax:252-247-3044
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC41311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC521973OtherUNITED CONCORDIA
NC99118OtherBLUE CROSS BLUE SHIELD NC
NC8999118Medicaid
NCU36642Medicare UPIN