Provider Demographics
NPI:1538714639
Name:WELLS, DIONNE JOI (DMD)
Entity type:Individual
Prefix:DR
First Name:DIONNE
Middle Name:JOI
Last Name:WELLS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 DEFOORS WALK NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-3003
Mailing Address - Country:US
Mailing Address - Phone:678-656-5349
Mailing Address - Fax:
Practice Address - Street 1:3805 DALLAS HWY SW STE 806
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1620
Practice Address - Country:US
Practice Address - Phone:678-203-3464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015942122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist