Provider Demographics
NPI:1821157801
Name:MICHAEL A. MAXWELL, D.D.S. AND AARON G. WELLS, D.D.S., LLC
Entity Type:Organization
Organization Name:MICHAEL A. MAXWELL, D.D.S. AND AARON G. WELLS, D.D.S., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:907-337-1322
Mailing Address - Street 1:6611 DEBARR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1706
Mailing Address - Country:US
Mailing Address - Phone:907-337-1322
Mailing Address - Fax:907-929-2178
Practice Address - Street 1:6611 DEBARR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1706
Practice Address - Country:US
Practice Address - Phone:907-337-1322
Practice Address - Fax:907-929-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK10661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty