Provider Demographics
NPI:1275041915
Name:WELCH, FENN HOLDEN (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:FENN
Middle Name:HOLDEN
Last Name:WELCH
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8551 W LAKE MEAD BLVD STE 261
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7642
Mailing Address - Country:US
Mailing Address - Phone:702-240-2300
Mailing Address - Fax:
Practice Address - Street 1:8551 W LAKE MEAD BLVD STE 261
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7642
Practice Address - Country:US
Practice Address - Phone:702-240-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS3-591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics