Provider Demographics
NPI:1902548522
Name:WATKINS, CHRISTIAN SEAN
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:SEAN
Last Name:WATKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7551 OSCEOLA POLK LINE RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-9112
Mailing Address - Country:US
Mailing Address - Phone:321-401-4540
Mailing Address - Fax:
Practice Address - Street 1:7551 OSCEOLA POLK LINE RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33896
Practice Address - Country:US
Practice Address - Phone:321-401-4540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL298141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program