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General NPI Number Information
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NPI Number | 1336798081
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Entity Type | Individual
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Provider Name | BROOKE BATEMAN DAII
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 1060 GODWIN DR
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City | WILLIAMSTON
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State | NC
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Zip | 27892-6827
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Country | US
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Telephone | 252-792-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 1139 NORTHSIDE RD
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-8525
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Country | US
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Telephone | 252-333-2648
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Fax |
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State | NC
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