Healthcare Provider Details

I. General information

NPI: 1538040639
Provider Name (Legal Business Name): TOBIE JO WELCH RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 567
SPRINGFIELD SD
57062-0567
US

IV. Provider business mailing address

412 POPLAR ST
AVON SD
57315-2015
US

V. Phone/Fax

Practice location:
  • Phone: 605-369-2226
  • Fax:
Mailing address:
  • Phone: 605-369-2226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH1883
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: