Individual
DR. MIALIKA KINYA WATKINS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1154 S BELLEVUE BLVD, MEMPHIS, TN 38106-3428
(901) 775-0870
(901) 789-7016
Mailing address
318 NICOLET DR, MEMPHIS, TN 38109-7456
(901) 830-9159
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7800
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14667
TENN CARE ID
TN
05
—
3205895
—
TN
Enumeration date
01/19/2006
Last updated
07/08/2007
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