Provider Demographics
NPI:1437201316
Name:THE WELSH DENTAL GROUP, P.A.
Entity Type:Organization
Organization Name:THE WELSH DENTAL GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-836-3711
Mailing Address - Street 1:1400 PEOPLES PLZ
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5707
Mailing Address - Country:US
Mailing Address - Phone:302-836-3711
Mailing Address - Fax:302-836-3488
Practice Address - Street 1:1400 PEOPLES PLZ
Practice Address - Street 2:SUITE 207
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5707
Practice Address - Country:US
Practice Address - Phone:302-836-3711
Practice Address - Fax:302-836-3488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG10001072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000034282Medicaid
MD09492OtherMARYLAND LICENSE
DEG10001072OtherDELAWARE LICENSE