Individual
RICHARD K WATASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
505 W BEVERLY BLVD, MONTEBELLO, CA 90640-3621
(323) 724-1330
(323) 724-4356
Mailing address
505 W BEVERLY BLVD, MONTEBELLO, CA 90640-3621
(323) 724-1330
(323) 724-4356
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
15910
CA
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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