Provider Demographics
NPI:1790876415
Name:WELLS, ANITA ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:ANN
Last Name:WELLS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11119 HEARTH RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608
Mailing Address - Country:US
Mailing Address - Phone:352-683-2283
Mailing Address - Fax:352-683-5504
Practice Address - Street 1:11119 HEARTH RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608
Practice Address - Country:US
Practice Address - Phone:352-683-2283
Practice Address - Fax:352-683-5504
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist