Provider Demographics
NPI:1366312811
Name:NICOLE WELLS DDS PLLC
Entity type:Organization
Organization Name:NICOLE WELLS DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYER ENROLLMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-869-3789
Mailing Address - Street 1:298 N NC 16 BUSINESS HWY STE E
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-8480
Mailing Address - Country:US
Mailing Address - Phone:704-483-1870
Mailing Address - Fax:704-483-1221
Practice Address - Street 1:298 N NC 16 BUSINESS HWY STE E
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-8480
Practice Address - Country:US
Practice Address - Phone:704-483-1870
Practice Address - Fax:704-483-1221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty