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General NPI Number Information
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NPI Number | 1972575645
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Entity Type | Individual
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Provider Name | JOHN FRANKLIN WATKINS III DENTIST DDS
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Gender | Male
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 110 W ENT AVE ATTN 2, 21DS/SGGD
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City | PETERSON AFB
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State | CO
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Zip | 80914-1540
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Country | US
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Telephone | 719-556-1333
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Fax | 719-556-1331
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Provider Business Mailing Address
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Address Line | 110 W ENT AVE ATTN 2, DS/SGGD
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City | PETERSON AFB
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State | CO
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Zip | 80914-1540
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Country | US
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Telephone | 719-556-1330
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Fax | 719-556-1331
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2981
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 17623
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License Number State | TX
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