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General NPI Number Information
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NPI Number | 1982910899
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Entity Type | Individual
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Provider Name | CORINNE A BATES DDS
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Gender | Female
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 08/30/2010
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Provider Practice Location Address
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Address Line | 3955 BAYLESS AVE STE 100
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City | SAINT LOUIS
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State | MO
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Zip | 63125-1439
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Country | US
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Telephone | 314-638-4190
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Fax | 314-638-3900
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Provider Business Mailing Address
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Address Line | 3955 BAYLESS AVE STE 100
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City | SAINT LOUIS
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State | MO
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Zip | 63125-1439
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Country | US
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Telephone | 314-638-4190
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Fax | 314-638-3900
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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 | 2010030266
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License Number State | MO
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