Provider Demographics
NPI:1265093009
Name:WELLING, SCOTT B (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:B
Last Name:WELLING
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 1:18825 CALDART AVE NE STE B
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8714
Mailing Address - Country:US
Mailing Address - Phone:614-623-3889
Mailing Address - Fax:
Practice Address - Street 1:18825 CALDART AVE NE STE B
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8714
Practice Address - Country:US
Practice Address - Phone:614-623-3889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609544201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice