Healthcare Provider Details

I. General information

NPI: 1649101213
Provider Name (Legal Business Name): CHRISTOPHER BATES DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 E 2050 N
CENTERVILLE UT
84014-1083
US

IV. Provider business mailing address

24 E 2050 N
CENTERVILLE UT
84014-1083
US

V. Phone/Fax

Practice location:
  • Phone: 509-420-0296
  • Fax:
Mailing address:
  • Phone: 509-420-0296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6209439-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: