Organization
KW BUSINESS ENTERPRISES
Active
Other names
Clear 3D Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL S WATSON D.D.S. (PRESIDENT/DENTIST)
(919) 621-5450
Entity
Organization
Contact information
Practice address
3769 SUNSET AVE STE 12, C/O CLEAR 3D IMAGING, ROCKY MOUNT, NC 27804-3327
(919) 621-5450
Mailing address
3769 SUNSET AVE STE 12, C/O CLEAR 3D IMAGING, ROCKY MOUNT, NC 27804-3327
(919) 621-5450
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6282
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8998922
—
NC
Enumeration date
02/09/2012
Last updated
02/09/2012
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