Healthcare Provider Details

I. General information

NPI: 1417135112
Provider Name (Legal Business Name): DONALD R. WELSH, JR. D.M.D.,P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 UNION ST
PORTSMOUTH NH
03801-5052
US

IV. Provider business mailing address

320 UNION ST
PORTSMOUTH NH
03801-5052
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-2144
  • Fax:
Mailing address:
  • Phone: 603-436-2144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2064
License Number StateNH

VIII. Authorized Official

Name: DR. DONALD R WELSH JR.
Title or Position: DENTIST
Credential: D.M.D.
Phone: 603-436-2144