Provider Demographics
NPI:1164551339
Name:CARRIE A. WATKINS, D.D.S.
Entity Type:Organization
Organization Name:CARRIE A. WATKINS, D.D.S.
Other - Org Name:DENTAL ASSOCIATES OF ATLANTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-804-0616
Mailing Address - Street 1:1100 ABERNATHY RD NE
Mailing Address - Street 2:BUILDING 500, SUITE 1020
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5646
Mailing Address - Country:US
Mailing Address - Phone:770-804-0616
Mailing Address - Fax:770-804-0520
Practice Address - Street 1:1100 ABERNATHY RD NE
Practice Address - Street 2:BUILDING 500, SUITE 1020
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5646
Practice Address - Country:US
Practice Address - Phone:770-804-0616
Practice Address - Fax:770-804-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA110621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty