Provider Demographics
NPI:1720182199
Name:WELDEN, JAMES M JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:WELDEN
Suffix:JR
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 1:2803 ROSS CLARK CIRCLE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301
Mailing Address - Country:US
Mailing Address - Phone:334-793-5397
Mailing Address - Fax:
Practice Address - Street 1:2803 ROSS CLARK CIRCLE
Practice Address - Street 2:SUITE #1
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301
Practice Address - Country:US
Practice Address - Phone:334-793-5397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL97397OtherBCBS OF ALABAMA