Individual
DEREK GENE WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
285 BLACK GOLD BLVD, HAZARD, KY 41701-2604
(606) 439-0881
(606) 439-1182
Mailing address
285 BLACK GOLD BLVD, HAZARD, KY 41701-2604
(606) 439-0881
(606) 439-1182
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7013
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60070133
—
KY
Enumeration date
08/01/2006
Last updated
02/25/2008
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