Provider Demographics
NPI:1891893905
Name:WATSON, ERNEST SPIERS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:SPIERS
Last Name:WATSON
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 1:941 SPRING ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-4546
Mailing Address - Country:US
Mailing Address - Phone:530-622-9412
Mailing Address - Fax:530-622-4192
Practice Address - Street 1:941 SPRING ST
Practice Address - Street 2:SUITE 6
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-4546
Practice Address - Country:US
Practice Address - Phone:530-622-9412
Practice Address - Fax:530-622-4192
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA281071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice