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NPI Code Detail

MEDICARE: WATTS ORTHODONTICS PC

MEDICARE: WATTS ORTHODONTICS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number : 1114500469
Entity Type Code : Organization
Provider Name (Legal Business Name) : WATTS ORTHODONTICS PC
Provider Business Mailing Address
First Line : 7560 RANGEWOOD DR STE 200
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-2100
Country : US
Telephone Number : 719-623-5396
Fax Number : 719-325-0244
Provider Business Practice Location Address
First Line : 6566 N MARKSHEFFEL RD # 200
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-4252
Country : US
Telephone Number : 719-596-3113
Fax Number : 719-325-0244
Authorized Official
Title or Position : OFFICE MANAGER
Name : CYNDIE LOU PLUID
Credential :
Telephone Number : 719-623-5396
Provider Enumeration Date : 05/04/2021
Last Update Date : 05/04/2021

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Directions to “WATTS ORTHODONTICS PC ” Practice Location

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