Provider Demographics
NPI:1619600715
Name:WELCH, JOSEPH HAYDEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HAYDEN
Last Name:WELCH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 PARK RD
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-2613
Mailing Address - Country:US
Mailing Address - Phone:307-789-5608
Mailing Address - Fax:
Practice Address - Street 1:50 PARK RD
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-2613
Practice Address - Country:US
Practice Address - Phone:307-789-5608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist