Provider Demographics
NPI:1063555399
Name:WELLS, THOMAS J (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
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 1:2550 DENALI ST
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2780
Mailing Address - Country:US
Mailing Address - Phone:907-277-4546
Mailing Address - Fax:907-278-1197
Practice Address - Street 1:2550 DENALI ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2780
Practice Address - Country:US
Practice Address - Phone:907-277-4546
Practice Address - Fax:907-278-1197
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK482122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist