DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JACK RANDALL WELLS JR., DDS

Active Sole Proprietor

DR. JACK RANDALL WELLS JR., DDS is a Dentist healthcare provider located in ALBUQUERQUE, New Mexico. NPI 1396345963 is currently active in the NPPES registry. Verify at CMS.

Dentist · ALBUQUERQUE, NM

Registration Details

NPI Number
1396345963
Provider Type
Individual
Gender
Male
NPI Issued
Oct 31, 2020 (5.7684712050919 yrs)
Last Updated
Oct 1, 2023
Licenses
DEN.00204532 (CO)
7425T (NV)
DB-2023-0092 (NM)
Sole Proprietor
Yes

Practice Information

Address
9201 EAGLE RANCH RD NW
ALBUQUERQUE, NM, 871146440
Browse NM providers · Browse ZIP 87114
Phone
5058929010
Primary Specialty
Dentist
122300000X
Additional Specialty
General Dentistry
Additional Specialty
Dentist

Other Dentist Providers in ALBUQUERQUE, NM

Name Credential NPI
JONATHAN Y CHIANG DDS 1598768129
DR. PAUL MARTIN CLIFFORD DDS 1134124126
DR. ALICIA ANN ABEYTA DDS 1942298047
DR. CLIFFORD FREIDLINE DDS 1154310928
CHARLES E TILSON DMD 1619966314
BRENTON MATTHEW MASON DMD 1336138031
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.