| Doctor Name: | MRS. KIM M WELCH |
| NPI Number: | 1255405478 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DDS |
| License Number: | D11308 |
| Business Practice Address: | 2385 Troop Drive Suite #201 Sartell, MN - 56377 |
| Business Phone Number: | 3202512972 |
| Business Fax Number: | 3202555514 |
| Mailing Address: | 2385 Troop Drive Suite #201, SARTELL |
| State: | MN |
| Postal Code: | 56377 |
| Phone Number: | 3202512972 |
| Fax Number: | 3202555514 |
| NPI Enumeration Date: | 11/20/2006 |
| NPI Last Update Date: | 09/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | D11308 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |