Gregory Lee Watford, D.M.D.

Individual provider Active NPI General Practice Dentistry · Kings Bay, GA

NPI 1629040381 · NPPES record last updated Mar 7, 2025

Key facts

NPI
1629040381
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN010254 (GA)
Practice address
871 Uss James Madison Rd
Kings Bay, GA 31547-2531
Phone
(912) 510-0679
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN010254GAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN010254 GA
General Practice Dentistry 1223G0001X DN010254 GA Yes

Addresses

Primary practice location

871 Uss James Madison Rd
Kings Bay, GA 31547-2531

Mailing address

26 London Hill LN
Woodbine, GA 31569-3926
Phone (912) 510-0679

Other providers in Kings Bay, GA

All providers in Kings Bay, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.