Provider Demographics
NPI:1366580078
Name:WATSTEIN, JOHN LINDER (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LINDER
Last Name:WATSTEIN
Suffix:
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 1:10905 FORT WASHINGTON ROAD
Mailing Address - Street 2:SUITE #407
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5807
Mailing Address - Country:US
Mailing Address - Phone:301-292-6220
Mailing Address - Fax:301-292-6228
Practice Address - Street 1:10905 FORT WASHINGTON ROAD
Practice Address - Street 2:SUITE #407
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5807
Practice Address - Country:US
Practice Address - Phone:301-292-6220
Practice Address - Fax:301-292-6228
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5812122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5812OtherBOARD OF DENTAL EXAMINERS