Provider Demographics
NPI:1770742934
Name:WATTS, DANTEY MAURICE (SURGICAL ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:DANTEY
Middle Name:MAURICE
Last Name:WATTS
Suffix:
Gender:M
Credentials:SURGICAL ASSISTANT
Other - Prefix:MR
Other - First Name:DANTEY
Other - Middle Name:MAURICE
Other - Last Name:WATTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SURGICAL ASSISTANT
Mailing Address - Street 1:4437 ESTATE ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-8846
Mailing Address - Country:US
Mailing Address - Phone:770-695-8444
Mailing Address - Fax:
Practice Address - Street 1:4437 ESTATE STREET
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-1808
Practice Address - Country:US
Practice Address - Phone:770-695-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant