Individual
DR. GARY LANE WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
501 PARK ST, PALMETTO, GA 30268-1007
(770) 463-4541
(770) 463-9184
Mailing address
501 PARK ST, PALMETTO, GA 30268-1007
(770) 463-4541
(770) 463-9184
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DNOO8627
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9180959
—
GA
Enumeration date
11/28/2006
Last updated
07/09/2007
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