Provider Demographics
NPI:1699838441
Name:WELCH, SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
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 1:421 W 104TH AVE
Mailing Address - Street 2:#201
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-4137
Mailing Address - Country:US
Mailing Address - Phone:303-427-6462
Mailing Address - Fax:303-487-7805
Practice Address - Street 1:421 W 104TH AVE
Practice Address - Street 2:#201
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4137
Practice Address - Country:US
Practice Address - Phone:303-427-6462
Practice Address - Fax:303-487-7805
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO64621223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery