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General NPI Number Information
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NPI Number | 1699116921
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Entity Type | Individual
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Provider Name | LEEANN SUE WELCH DMD, MPH
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Gender | Female
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 2522 NW 13TH ST
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City | REDMOND
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State | OR
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Zip | 97756-1197
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Country | US
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Telephone | 541-480-6378
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Fax |
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Provider Business Mailing Address
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Address Line | 903 LADD AVE
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City | JUNCTION CITY
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State | OR
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Zip | 97448-8606
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Country | US
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Telephone | 541-480-6378
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D008687
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License Number State | AZ
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