Healthcare Provider Details

I. General information

NPI: 1073519765
Provider Name (Legal Business Name): FRANKLIN MCCHESNEY WATSON II D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date: 03/23/2006
Reactivation Date: 08/23/2006

III. Provider practice location address

428 E. COLLEGE AVE.
TALLAHASSEE FL
32301
US

IV. Provider business mailing address

4484 SW MOSELY HALL RD
GREENVILLE FL
32331-3994
US

V. Phone/Fax

Practice location:
  • Phone: 850-224-1213
  • Fax:
Mailing address:
  • Phone: 407-351-3213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: