Individual
TERRY LEE MCWATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2201 22ND STREET, NITRO, WV 25143
(304) 755-2161
(304) 755-7140
Mailing address
2201 22ND STREET, NITRO, WV 25143
(304) 755-2161
(304) 755-7140
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2893
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00608566
OSCAR
WV
05
—
0132649000
—
WV
Enumeration date
09/02/2006
Last updated
07/08/2007
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