Provider Demographics
NPI:1235299629
Name:R PATRICK WELSH DDS PA
Entity type:Organization
Organization Name:R PATRICK WELSH DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROWLAND
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PA
Authorized Official - Phone:601-956-2944
Mailing Address - Street 1:5858 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211
Mailing Address - Country:US
Mailing Address - Phone:601-956-2944
Mailing Address - Fax:601-956-3358
Practice Address - Street 1:5858 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211
Practice Address - Country:US
Practice Address - Phone:601-956-2944
Practice Address - Fax:601-956-3358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS142170122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty