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General NPI Number Information
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NPI Number | 1336322858
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Entity Type | Organization
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Legal Business Name | JOHN LEE BATES, D.D.S.,P.A.
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 504 MULBERRY ST SW
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City | LENOIR
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State | NC
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Zip | 28645-5761
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Country | US
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Telephone | 828-438-2880
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7
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City | JONAS RIDGE
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State | NC
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Zip | 28641-0007
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Country | US
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Telephone | 704-651-7908
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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. JOHN L BATES
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Credential | DDS
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Telephone | 704-651-7908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4465
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License Number State | NC
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