Provider Demographics
NPI:1548887672
Name:WATKINS, CHELSEA Q (DDS)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:Q
Last Name:WATKINS
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 1:3684 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3375
Mailing Address - Country:US
Mailing Address - Phone:248-642-1000
Mailing Address - Fax:248-642-1004
Practice Address - Street 1:3684 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-3375
Practice Address - Country:US
Practice Address - Phone:248-642-1000
Practice Address - Fax:248-642-1004
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016004971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice