Provider Demographics
NPI:1841476876
Name:WELLS, MARVEL & HALL, L.L.C.
Entity type:Organization
Organization Name:WELLS, MARVEL & HALL, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTGOMERY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MARVEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-342-7090
Mailing Address - Street 1:829 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-3236
Mailing Address - Country:US
Mailing Address - Phone:765-342-7090
Mailing Address - Fax:765-342-6703
Practice Address - Street 1:829 PLAZA DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-3236
Practice Address - Country:US
Practice Address - Phone:765-342-7090
Practice Address - Fax:765-342-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty