Provider Demographics
NPI:1902028467
Name:WATTS, JAMES DUSTIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DUSTIN
Last Name:WATTS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:201 E LAYFAIR DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7604
Mailing Address - Country:US
Mailing Address - Phone:601-664-1855
Mailing Address - Fax:601-664-1856
Practice Address - Street 1:201 E LAYFAIR DR
Practice Address - Street 2:SUITE 120
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7604
Practice Address - Country:US
Practice Address - Phone:601-664-1855
Practice Address - Fax:601-664-1856
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3143-001223E0200X
VA04014119451223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics