Provider Demographics
NPI:1265494652
Name:WELCH, DENNIS BRUCE (DDS)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:BRUCE
Last Name:WELCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12233 116TH AVE NE
Mailing Address - Street 2:#203
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-820-6100
Mailing Address - Fax:425-821-5188
Practice Address - Street 1:12233 116TH AVE NE
Practice Address - Street 2:#203
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-820-6100
Practice Address - Fax:425-821-5188
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5341122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist