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Individual

DR. ROBERT T WATTS, JR

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1760 MEDICAL PARK DR, SUITE A, BILOXI, MS 39532-2131
(228) 388-5925
(228) 388-8153
Mailing address
1525 E PASS RD, APT 222, GULFPORT, MS 39507-3548
(228) 388-5925
(228) 388-8153

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
237987
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7951005
MS
Enumeration date
05/18/2006
Last updated
07/08/2007
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