Provider Demographics
NPI:1093874596
Name:WELCH, SARAH ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANN
Last Name:WELCH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 GRAHAM AVE
Mailing Address - Street 2:APT 154
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3090
Mailing Address - Country:US
Mailing Address - Phone:651-207-1787
Mailing Address - Fax:
Practice Address - Street 1:14990 GLAZIER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7818
Practice Address - Country:US
Practice Address - Phone:952-431-5114
Practice Address - Fax:952-431-3576
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND122491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice