Individual
KATHRYN TEAL WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D., M.S.
Contact information
Practice address
5305345 VINING ST NW, #201, CONCORD, NC 28027
(704) 784-4625
Mailing address
5345 VINING ST NW, #201, CONCORD, NC 28027-2938
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
11130
NC
Other
Enumeration date
05/18/2016
Last updated
01/06/2020
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