Provider Demographics
NPI:1902968159
Name:WATKIS-BYNOE, EVA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:MARIE
Last Name:WATKIS-BYNOE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 HELEN LN
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-4034
Mailing Address - Country:US
Mailing Address - Phone:972-222-8262
Mailing Address - Fax:
Practice Address - Street 1:8228 BRUTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-1902
Practice Address - Country:US
Practice Address - Phone:214-398-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22789122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist