Healthcare Provider Details

I. General information

NPI: 1790994341
Provider Name (Legal Business Name): GREGG WELSH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 SOUTH LA CUMBRE RD STE 5
SANTA BARBARA CA
93105
US

IV. Provider business mailing address

38 SOUTH LA CUMBRE RD STE 5
SANTA BARBARA CA
93105
US

V. Phone/Fax

Practice location:
  • Phone: 805-692-8500
  • Fax: 805-692-8600
Mailing address:
  • Phone: 805-692-8500
  • Fax: 805-692-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number22563
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: