Organization
DEREK G. WATTS, D.M.D.,M.S.,P.S.C.
Active
Organization
DEREK G. WATTS, D.M.D.,M.S.,P.S.C.
Active
Other names
Hazard Orthodontic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK GENE WATTS D.M.D.,M.S. (PRESIDENT)
(606) 439-0881
Entity
Organization
Contact information
Practice address
285 BLACK GOLD BLVD, HAZARD, KY 41701-2604
(606) 439-0881
(606) 439-1182
Mailing address
285 BLACK GOLD BLVD, HAZARD, KY 41701-2604
(606) 439-0881
(606) 439-1182
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7013
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60070133
—
KY
Enumeration date
08/01/2006
Last updated
02/25/2008
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