Individual
KEITH EDWARD WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1832 N LOMBARD ST, PORTLAND, OR 97217-5662
(503) 235-3002
(503) 235-0084
Mailing address
1832 N LOMBARD ST, PORTLAND, OR 97217-5662
(503) 235-3002
(503) 235-0084
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8220
OR
Other
Enumeration date
01/17/2006
Last updated
08/12/2022
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