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General NPI Number Information
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NPI Number | 1205293081
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Entity Type | Organization
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Legal Business Name | CHESTER ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 6425 CHESTERFIELD MEADOWS DR
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City | CHESTERFIELD
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State | VA
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Zip | 23832-8810
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Country | US
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Telephone | 804-477-4210
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 STILLMAN PKWY SUITE 101
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City | RICHMOND
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State | VA
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Zip | 23233-1455
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHELDON BATES
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Credential | DMD, MSD
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Telephone | 804-477-4210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401413495
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License Number State | VA
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