Provider Demographics
NPI:1790472637
Name:DAVID WELTON DDS, P.C.
Entity Type:Organization
Organization Name:DAVID WELTON DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFOO
Authorized Official - Prefix:
Authorized Official - First Name:MIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-919-1471
Mailing Address - Street 1:15701 E SPRAGUE AVE STE F
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-5019
Mailing Address - Country:US
Mailing Address - Phone:509-919-1471
Mailing Address - Fax:509-381-5382
Practice Address - Street 1:15701 E SPRAGUE AVE STE F
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-5019
Practice Address - Country:US
Practice Address - Phone:509-919-1471
Practice Address - Fax:509-381-5382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty