Provider Demographics
NPI:1942048491
Name:WATSON, ROBERT MAXWELL (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MAXWELL
Last Name:WATSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:MAXWELL
Other - Middle Name:
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-793-2695
Mailing Address - Fax:401-444-4165
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-793-2695
Practice Address - Fax:401-444-4165
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program