Individual
KRISTEN WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2958 DOUGHERTY FERRY RD, SAINT LOUIS, MO 63122-3366
(636) 394-4275
Mailing address
1238 ARCH TER, SAINT LOUIS, MO 63117-1402
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2020038493
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095967151
UNITED HEALTHCARE
MO
Enumeration date
04/15/2020
Last updated
07/03/2024
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