Provider Demographics
NPI:1558920199
Name:WELSH, EILISH LYNN (DMD)
Entity type:Individual
Prefix:DR
First Name:EILISH
Middle Name:LYNN
Last Name:WELSH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 DEAVEN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-6897
Mailing Address - Country:US
Mailing Address - Phone:717-829-3450
Mailing Address - Fax:
Practice Address - Street 1:1824 PEARL RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3252
Practice Address - Country:US
Practice Address - Phone:330-220-6363
Practice Address - Fax:330-294-5652
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0258691223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1223P0221XDental ProvidersDentistPediatric Dentistry