Provider Demographics
NPI:1497750095
Name:WELCH DENTAL GROUP, INC
Entity Type:Organization
Organization Name:WELCH DENTAL GROUP, INC
Other - Org Name:GARY D. WELCH, DDS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT (OWNER)
Authorized Official - Prefix:MR
Authorized Official - First Name:DUC
Authorized Official - Middle Name:M
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-395-2112
Mailing Address - Street 1:23515 KINGSLAND BLVD.
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494
Mailing Address - Country:US
Mailing Address - Phone:281-395-2112
Mailing Address - Fax:281-395-4706
Practice Address - Street 1:23515 KINGSLAND BLVD.
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:281-395-2112
Practice Address - Fax:281-395-4706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty