Provider Demographics
NPI:1033323597
Name:WATSON, VALERIE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:M
Last Name:WATSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 HEBRON PARK DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-9534
Mailing Address - Country:US
Mailing Address - Phone:859-689-2021
Mailing Address - Fax:
Practice Address - Street 1:2940 HEBRON PARK DR
Practice Address - Street 2:SUITE 104
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-9534
Practice Address - Country:US
Practice Address - Phone:859-689-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.022702122300000X
KY84361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist