| Organization Name: | WELCH DENTAL CENTER, PLLC |
| NPI Number: | 1841475217 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JONATHAN R. WELCH (SECRETARY) |
| Mailing Address: | 1408 James Blvd Signal Mountain |
| State: | TN US |
| Postal Code: | 373772630 |
| Phone Number: | 4238863649 |
| Fax Number: | 4238862726 |
| NPI Enumeration Date: | 01/04/2008 |
| NPI Last Update Date: | 01/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DS8255 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |