Individual
DR. PHILLIP E. WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
814
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117446100
TITLE 19
WY
Enumeration date
11/17/2005
Last updated
02/05/2016
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