Individual
DR. CRYSTAL GRACE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2620 NEW BERN AVENUE, NEW BERN RIDGE DENTAL CENTER, RALEIGH, NC 27610
(919) 250-2930
(919) 231-8077
Mailing address
2168 PERSIMMON RIDGE DRIVE, RALEIGH, NC 27604
(919) 760-3084
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8221
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5904004
—
NC
01
—
9027F
BLUE CROSS BLUE SHIELD
NC
Enumeration date
11/15/2006
Last updated
06/23/2011
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