Provider Demographics
NPI:1073635637
Name:WATSON, STEPHEN C JR (DDS, MS, PC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
Last Name:WATSON
Suffix:JR
Gender:M
Credentials:DDS, MS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4724 SWEETWATER BLVD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3149
Mailing Address - Country:US
Mailing Address - Phone:281-491-5655
Mailing Address - Fax:281-491-0058
Practice Address - Street 1:4724 SWEETWATER BLVD
Practice Address - Street 2:SUITE #101
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3149
Practice Address - Country:US
Practice Address - Phone:281-491-5655
Practice Address - Fax:281-491-0058
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX176641223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics