Individual
CHARLES OTTO WATKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1399 GENEVA AVE N, SUITE 101, OAKDALE, MN 55128-5709
(651) 731-6464
Mailing address
3076 SHOREWOOD LN, ROSEVILLE, MN 55113-1401
(651) 633-3443
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9471
MN
Other
Enumeration date
09/03/2006
Last updated
07/08/2007
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