Basic Information
| Provider Information | |||||||||
| NPI: | 1689257834 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WATTS ORTHODONTICS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7560 RANGEWOOD DR STE 200 | ||||||||
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| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809202100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196235396 | ||||||||
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| Practice Location | |||||||||
| Address1: | 451 RAMPART RANGE RD | ||||||||
| Address2: | |||||||||
| City: | WOODLAND PARK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 808632428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195963113 | ||||||||
| FaxNumber: | 7193250244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2021 | ||||||||
| LastUpdateDate: | 05/04/2021 | ||||||||
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| AuthorizedOfficialLastName: | PLUID | ||||||||
| AuthorizedOfficialFirstName: | CYNDIE | ||||||||
| AuthorizedOfficialMiddleName: | LOU | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGAGER | ||||||||
| AuthorizedOfficialTelephone: | 7196235396 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.