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General NPI Number Information
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NPI Number | 1801032875
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Entity Type | Individual
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Provider Name | GREGORY LYNN WATKINS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 921 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5007
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Country | US
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Telephone | 405-456-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 3133 SW 140TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170-5855
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Country | US
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Telephone | 405-735-7818
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3652
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License Number State | OK
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