Healthcare Provider Details

I. General information

NPI: 1972782472
Provider Name (Legal Business Name): ERIK ALEXANDER WATSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 RIDGECREST DR SE BLDG B
ALBUQUERQUE NM
87108-5129
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-658-8236
  • Fax: 505-640-0911
Mailing address:
  • Phone: 505-272-1476
  • Fax: 505-753-5815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDD3478
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: