Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 6297 | AL |
NPI | 1003350059 |
---|---|
Provider Name | Dr. Yokeca Nicole Watts |
First Address | Birmingham, AL 35217-2855 |
Second Address | Bessemer, AL 35022-7304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2016 |
Last Update Date | 10/12/2016 |