MEDICARE: DR. CHET EDWARD WELKER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2012022760	MO

General Provider Information

NPI Number	:	1063766004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHET EDWARD WELKER DDS

Provider Business Mailing Address
First Line	:	819 WALNUT ST
Second Line	:	SUITE 101
City	:	KANSAS CITY
State	:	MO
Zip	:	64106-1810
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	819 WALNUT ST
Second Line	:	SUITE 101
City	:	KANSAS CITY
State	:	MO
Zip	:	64106-1810
Country	:	US
Telephone Number	:	816-421-6067
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2012
Last Update Date	:	10/30/2012

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