Watters, Gayle

Watters, Gayle is an individual health care provider with primary practice located at 7728 Old Canton Road Suite A, Madison MS 39110. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Watters, Gayle can be contacted via phone (601) 856-1511.

Contact Information

Primary practice address
7728 Old Canton Road Suite A Madison MS 39110
Phone: (601) 856-1511
Fax: (601) 856-1011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 315800 Mississippi
Dental Providers / Pediatric Dentistry 1223P0221X 3158-00 Mississippi

Profile Details

NPI number 1265571491
LBN Legal business name Watters, Gayle
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Oct 24th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265571491 NPPES
Mississippi MEDICAID 00660446

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