Syretta Wells, DDS
Dentist, Prosthodontics in Forest Park, GA. Individual provider (NPI-1).
NPI number1184875882
StatusActive
Last updated in NPPESOct 1, 2008
Details
- NPI
- 1184875882
- Entity type
- Individual (NPI-1)
- Name
- Ms. Syretta Wells
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 1, 2008
- Last updated
- Oct 1, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0700X | Dentist, Prosthodontics | DN13505 | GA | Yes |
| 1223G0001X | Dentist, General Practice | DN13505 | GA |
Practice location
4930 Governors DrSuite 405
Forest Park, GA 30297-6101
Phone 404-363-1700 · Fax 404-363-0700
Mailing address
4930 Governors DrSuite 405
Forest Park, GA 30297-6101
Phone 404-363-1700 · Fax 404-363-0700
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