Provider Demographics
NPI:1467450288
Name:WATTS DENTAL PLLC
Entity Type:Organization
Organization Name:WATTS DENTAL PLLC
Other - Org Name:PEDIATRIC DENTAL PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:DAWSON
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:512-346-9771
Mailing Address - Street 1:9015 MOUNTAIN RIDGE DR
Mailing Address - Street 2:STE 320
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7370
Mailing Address - Country:US
Mailing Address - Phone:512-346-9771
Mailing Address - Fax:512-343-8111
Practice Address - Street 1:9015 MOUNTAIN RIDGE DR
Practice Address - Street 2:STE 320
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7370
Practice Address - Country:US
Practice Address - Phone:512-346-9771
Practice Address - Fax:512-343-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental