Provider Demographics
NPI:1285967109
Name:WELLS, ZACHARY (DMD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:WELLS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6850 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3024
Mailing Address - Country:US
Mailing Address - Phone:303-758-6850
Mailing Address - Fax:303-458-0729
Practice Address - Street 1:6850 E HAMPDEN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3024
Practice Address - Country:US
Practice Address - Phone:303-758-6850
Practice Address - Fax:303-458-0729
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2018611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82557047Medicaid