Provider Demographics
NPI:1801192513
Name:W & W MANAGEMENT INC
Entity Type:Organization
Organization Name:W & W MANAGEMENT INC
Other - Org Name:COASTAL BEND DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:WATT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:361-776-5166
Mailing Address - Street 1:2797 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362-5901
Mailing Address - Country:US
Mailing Address - Phone:361-776-5166
Mailing Address - Fax:
Practice Address - Street 1:2797 MAIN ST
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362-5901
Practice Address - Country:US
Practice Address - Phone:361-776-5166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19493122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty