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General NPI Number Information
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NPI Number | 1609945344
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Entity Type | Organization
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Legal Business Name | DR JOHN Q WATSON DDS MSCO PA
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/28/2007
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Provider Practice Location Address
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Address Line | 2250 NASH ST N
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City | WILSON
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State | NC
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Zip | 27896
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Country | US
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Telephone | 252-291-5977
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Fax | 252-234-0370
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Provider Business Mailing Address
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Address Line | 2250 NASH ST N
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City | WILSON
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State | NC
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Zip | 27896
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Country | US
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Telephone | 252-291-5977
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Fax | 252-234-0370
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN QUANTOCK WATSON
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Credential | DDS
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Telephone | 252-291-5977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3840
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License Number State | NC
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