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Organization
WATSON PSC DBA WEST LOUISVILLE DENTAL CENTER
Active
Organization
WATSON PSC DBA WEST LOUISVILLE DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KWANE MITCHELL WATSON D.M.D. (OWNER)
(502) 776-1754
Entity
Organization
Contact information
Practice address
2500 W BROADWAY, LOUISVILLE, KY 40211-1081
(502) 776-1754
Mailing address
2500 W BROADWAY, LOUISVILLE, KY 40211-1081
(502) 776-1754
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/28/2007
Last updated
09/01/2010
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