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General NPI Number Information
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NPI Number | 1285769315
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Entity Type | Individual
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Provider Name | JOHN R BATES DDS
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Gender | Male
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 701 S JOHN REDDITT DR
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City | LUFKIN
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State | TX
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Zip | 75904-4313
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Country | US
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Telephone | 936-634-5012
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Fax | 936-634-4609
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Provider Business Mailing Address
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Address Line | 701 S JOHN REDDITT DR
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City | LUFKIN
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State | TX
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Zip | 75904-4313
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Country | US
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Telephone | 936-634-5012
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Fax | 936-634-4609
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9848
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License Number State | TX
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