Organization
AZ RED MOUNTAIN PEDIATRIC DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED W WELCH D.D.S. (OWNER)
(480) 917-9339
Entity
Organization
Contact information
Practice address
9101 E BROWN RD, 102, MESA, AZ 85207-4350
(480) 565-8500
Mailing address
9101 E BROWN RD, 102, MESA, AZ 85207-4350
(480) 565-8500
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5685
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
821497
—
AZ
05
—
914227
—
AZ
Enumeration date
08/04/2016
Last updated
08/04/2016
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