Provider Demographics
NPI:1972575645
Name:WATKINS, JOHN FRANKLIN III (DENTIST DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANKLIN
Last Name:WATKINS
Suffix:III
Gender:M
Credentials:DENTIST DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W ENT AVE
Mailing Address - Street 2:ATTN 2, DS/SGGD
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-556-1330
Mailing Address - Fax:719-556-1331
Practice Address - Street 1:110 W ENT AVE
Practice Address - Street 2:ATTN 2, 21DS/SGGD
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-1333
Practice Address - Fax:719-556-1331
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2981122300000X
TX17623122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist