Individual
DR. GARY LYNN WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
20280 N 59TH AVE STE 104, GLENDALE, AZ 85308-6846
(623) 748-7299
Mailing address
2624 S ROWEN, MESA, AZ 85209-6271
(480) 924-7959
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4446
AZ
1223G0001X
General Practice Dentistry
AZD04446
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167032
—
AZ
05
—
64409236
—
NM
Enumeration date
11/20/2006
Last updated
04/17/2016
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