Individual
DR. DOUGLAS T. WATANABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2821 N BALLAS RD, SUITE 140, SAINT LOUIS, MO 63131-2321
(314) 432-5544
(314) 432-7815
Mailing address
2821 N BALLAS RD, SUITE 140, SAINT LOUIS, MO 63131-2321
(314) 432-5544
(314) 432-7815
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11564
MO
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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