| NPI | 1386691343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT T WATTS, JR Physicain/Owner 228-388-5925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-08-22 |