Healthcare Provider Details

I. General information

NPI: 1497750095
Provider Name (Legal Business Name): WELCH DENTAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23515 KINGSLAND BLVD.
KATY TX
77494
US

IV. Provider business mailing address

23515 KINGSLAND BLVD.
KATY TX
77494
US

V. Phone/Fax

Practice location:
  • Phone: 281-395-2112
  • Fax: 281-395-4706
Mailing address:
  • Phone: 281-395-2112
  • Fax: 281-395-4706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8864
License Number StateTX

VIII. Authorized Official

Name: MR. DUC M HO
Title or Position: PRESIDENT (OWNER)
Credential: DDS
Phone: 281-395-2112