Provider Demographics
NPI:1417070830
Name:WATKINS, RONALD H (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:H
Last Name:WATKINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 E CAMELBACK RD
Mailing Address - Street 2:E-100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2843
Mailing Address - Country:US
Mailing Address - Phone:602-840-4100
Mailing Address - Fax:602-952-8698
Practice Address - Street 1:4455 E CAMELBACK RD
Practice Address - Street 2:E-100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2843
Practice Address - Country:US
Practice Address - Phone:602-840-4100
Practice Address - Fax:602-952-8698
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15851223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics