Provider Demographics
NPI:1467625152
Name:WELDON DENTAL CARE
Entity Type:Organization
Organization Name:WELDON DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:RELF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-277-1088
Mailing Address - Street 1:3806 N 3RD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2016
Mailing Address - Country:US
Mailing Address - Phone:602-277-1088
Mailing Address - Fax:602-277-0552
Practice Address - Street 1:3806 N 3RD ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2016
Practice Address - Country:US
Practice Address - Phone:602-277-1088
Practice Address - Fax:602-277-0552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty