# WATSON DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lynda R. Watson, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679940647
- **Authorized official:** MRS. LYNDA ROBIN WATSON D.D.S (DENTIST)
- **Authorized official phone:** (913) 381-4090

## Contact information

- **Practice address:** 11538 W 119TH ST, OVERLAND PARK, KS 66213-2002
- **Practice address phone:** (913) 381-4090
- **Practice address fax:** (913) 381-4419
- **Mailing address:** 11538 W 119TH ST, OVERLAND PARK, KS 66213-2002
- **Mailing address phone:** (913) 381-4090
- **Mailing address fax:** (913) 381-4419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 6608 | KS | Yes |

## Other

- **Enumeration date:** 08/26/2015
- **Last updated:** 08/26/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 15370032 | BLUE CROSS BLUE SHIELD | KS |