Provider Demographics
NPI:1053488650
Name:WELCH, JARED WESTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:WESTON
Last Name:WELCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3011 S LINDSAY RD STE 108
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-0702
Mailing Address - Country:US
Mailing Address - Phone:480-917-9339
Mailing Address - Fax:480-821-2980
Practice Address - Street 1:3011 S LINDSAY RD STE 108
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-0702
Practice Address - Country:US
Practice Address - Phone:480-917-9339
Practice Address - Fax:480-821-2980
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry