Provider Demographics
NPI:1407864416
Name:WATTS, JAMES PAUL (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PAUL
Last Name:WATTS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 DENISON AVE
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2710
Mailing Address - Country:US
Mailing Address - Phone:860-536-6446
Mailing Address - Fax:860-536-0388
Practice Address - Street 1:85 DENISON AVE
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2710
Practice Address - Country:US
Practice Address - Phone:860-536-6446
Practice Address - Fax:860-536-0388
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTD04872122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist