Provider Demographics
NPI:1679782015
Name:WELCH, LANDMAN & VALLERA, P.C.
Entity type:Organization
Organization Name:WELCH, LANDMAN & VALLERA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATION PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:LANDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:413-734-0416
Mailing Address - Street 1:75 VAN DEENE AVE
Mailing Address - Street 2:101
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3258
Mailing Address - Country:US
Mailing Address - Phone:413-746-4766
Mailing Address - Fax:
Practice Address - Street 1:75 VAN DEENE AVE
Practice Address - Street 2:101
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3258
Practice Address - Country:US
Practice Address - Phone:413-746-4766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty