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DR. MIRIAM PERDOMO-WATTS DMD

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1881750446

Individual Registrant:
DR. MIRIAM  PERDOMO-WATTS DMD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
18471 WILTERS STREET  ROBERTSDALE, AL 36567 US
Tel: 251-947-3636  Fax: 251-947-3637

Contact information for business:
1121 S MCKENZIE ST  FOLEY, AL 36535-1816 US
Tel: 251-233-3246  Fax: --

Registration Information:
NPI: 1881750446
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N1223G0001XDental Providers
Dentist
General Practice
GA13309
Y1223G0001XDental Providers
Dentist
AL5105

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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