Individual
DR. DAMON OMAR WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
6031 HARBOUR PARK DR, MIDLOTHIAN, VA 23112-2160
(804) 608-3200
(804) 608-3201
Mailing address
11545 A NUCKOLS ROAD, GLEN ALLEN, VA 23059-5666
(804) 673-8061
(804) 673-5644
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401412132
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2901018153
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
0438000245
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901018153
DENTAL LICENSE NUMBER
MI
Enumeration date
07/06/2007
Last updated
08/02/2018
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