Wells, Wavel Lou

Wells, Wavel Lou is an sole proprietor health care provider with primary practice located at 4417 W Gore Blvd Ste 11 , Lawton OK 73505-5978. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Wells, Wavel Lou can be contacted via phone (580) 248-8418.

Contact Information

Primary practice address
4417 W Gore Blvd Ste 11 Lawton OK 73505-5978
Fax: (580) 248-4118
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 3494 Oklahoma

Profile Details

NPI number 1376642041
LBN Legal business name Wells, Wavel Lou
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2006
Last updated May 16th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376642041 NPPES
Oklahoma MEDICAID 100194430A

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