Organization
TERRELL A WATERS DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRELL ANTHONY WATERS DDS (PRESIDENT)
(202) 562-8827
Entity
Organization
Contact information
Practice address
4300 WHEELER ROAD SE, WASHINGTON, DC 20032-6036
(202) 562-8827
(202) 563-4160
Mailing address
4300 WHEELER ROAD SE, WASHINGTON, DC 20032-6036
(202) 562-8827
(202) 563-4160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3829
MD
1223G0001X
General Practice Dentistry
Primary
DEN2248
DC
1223G0001X
General Practice Dentistry
DN10233
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104664
DORAL
—
Enumeration date
10/04/2006
Last updated
08/22/2020
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