Provider Demographics
NPI:1710319298
Name:WELLS, LAUREN ASHLEY
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ASHLEY
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 S 3200 W
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129-2822
Mailing Address - Country:US
Mailing Address - Phone:801-964-6214
Mailing Address - Fax:801-982-9232
Practice Address - Street 1:7985 E 16TH AVE # 300
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2896
Practice Address - Country:US
Practice Address - Phone:907-333-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA627701223G0001X
AK134667122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice