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General NPI Number Information
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NPI Number | 1609949262
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Entity Type | Individual
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Provider Name | STEVEN RUSSELL BATES D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6518 DORCHESTER RD SUITE A
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City | NORTH CHARLESTON
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State | SC
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Zip | 29418-5100
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Country | US
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Telephone | 843-767-1809
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Fax | 843-767-9244
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Provider Business Mailing Address
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Address Line | 140 BEAVERTON CT
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City | SUMMERVILLE
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State | SC
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Zip | 29485-6011
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Country | US
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Telephone | 843-873-7005
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2773
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License Number State | SC
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