Individual
DR. MICHAEL TODD WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
52 S. MAIN ST., SUITE A, KENT CITY, MI 49330
(616) 678-4040
(616) 678-5194
Mailing address
52 S. MAIN ST., P.O. BOX 300, KENT CITY, MI 49330
(616) 678-4040
(616) 678-5194
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901014777
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1825607
—
MI
01
—
2901014777
DENTAL LICENSE ID NUMBER
MI
Enumeration date
08/07/2006
Last updated
07/08/2007
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