Provider Demographics
NPI:1184911182
Name:WELSH, JESSE CARVER (DDS)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:CARVER
Last Name:WELSH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37060-4510
Mailing Address - Country:US
Mailing Address - Phone:615-274-2525
Mailing Address - Fax:
Practice Address - Street 1:359 S MAIN ST
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37060-4510
Practice Address - Country:US
Practice Address - Phone:615-274-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9270122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist