Provider Demographics
NPI:1144436080
Name:WATSON, ROBERT HUGH JR (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HUGH
Last Name:WATSON
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 ABBEY PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3736
Mailing Address - Country:US
Mailing Address - Phone:704-523-7221
Mailing Address - Fax:704-523-4933
Practice Address - Street 1:1720 ABBEY PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3736
Practice Address - Country:US
Practice Address - Phone:704-523-7221
Practice Address - Fax:704-523-4933
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC51951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice