Provider Demographics
NPI:1891135083
Name:TERRY L. WATSON DMD PA
Entity Type:Organization
Organization Name:TERRY L. WATSON DMD PA
Other - Org Name:ALL ABOUT SMILES FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-994-7645
Mailing Address - Street 1:1171 HIGHWAY 62 412
Mailing Address - Street 2:
Mailing Address - City:ASH FLAT
Mailing Address - State:AR
Mailing Address - Zip Code:72513-9612
Mailing Address - Country:US
Mailing Address - Phone:870-994-7645
Mailing Address - Fax:870-994-3566
Practice Address - Street 1:1171 HIGHWAY 62 412
Practice Address - Street 2:
Practice Address - City:ASH FLAT
Practice Address - State:AR
Practice Address - Zip Code:72513-9612
Practice Address - Country:US
Practice Address - Phone:870-994-7645
Practice Address - Fax:870-994-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty