Provider Demographics
NPI:1942530688
Name:MARTIN & WELCH PC GOLDEN VIEW DENTAL
Entity Type:Organization
Organization Name:MARTIN & WELCH PC GOLDEN VIEW DENTAL
Other - Org Name:GOLDEN VIEW DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-548-5978
Mailing Address - Street 1:727 SIMMS ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-4792
Mailing Address - Country:US
Mailing Address - Phone:303-232-3636
Mailing Address - Fax:
Practice Address - Street 1:727 SIMMS ST
Practice Address - Street 2:SUITE E
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-4792
Practice Address - Country:US
Practice Address - Phone:303-232-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO64621223G0001X
CO2631124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty