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NPI Code Detail

MEDICARE: DR. TODD ALAN WELCH D.M.D.

MEDICARE: DR. TODD ALAN WELCH D.M.D.
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
11223P0300XPeriodonticsDS8323TN

General Provider Information

NPI Number : 1710991302
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD ALAN WELCH D.M.D.
Provider Business Mailing Address
First Line : 39 MURRAY GUARD DR
Second Line :
City : JACKSON
State : TN
Zip : 38305-3610
Country : US
Telephone Number : 731-215-2347
Fax Number : 731-215-2387
Provider Business Practice Location Address
First Line : 39 MURRAY GUARD DR
Second Line :
City : JACKSON
State : TN
Zip : 38305-3610
Country : US
Telephone Number : 731-215-2347
Fax Number : 731-215-2387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 06/07/2010

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