Individual
DR. KWANE MITCHELL WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2500 W BROADWAY, LOUISVILLE, KY 40211-1081
(502) 776-1754
Mailing address
5906 WORTHINGTON WAY, PROSPECT, KY 40059-8554
(502) 523-2347
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7483
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60000072
—
KY
Enumeration date
01/17/2007
Last updated
03/19/2025
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