Provider Demographics
NPI:1497800999
Name:WATSON, JOSEPH GERALD (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GERALD
Last Name:WATSON
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 1:3385 BURNS RD STE 206
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4328
Mailing Address - Country:US
Mailing Address - Phone:561-691-0700
Mailing Address - Fax:561-691-0707
Practice Address - Street 1:3385 BURNS RD STE 206
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4328
Practice Address - Country:US
Practice Address - Phone:561-691-0700
Practice Address - Fax:561-691-0707
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN109901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice