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NPI Code Detail

MEDICARE: ED BATEMAN DDS A PROFESSIONAL DENTAL CORPORATION

MEDICARE: ED BATEMAN DDS A PROFESSIONAL DENTAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry1584LA

General Provider Information

NPI Number : 1164681003
Entity Type Code : Organization
Provider Name (Legal Business Name) : ED BATEMAN DDS A PROFESSIONAL DENTAL CORPORATION
Provider Business Mailing Address
First Line : 748 CHEVELLE DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6503
Country : US
Telephone Number : 225-927-5095
Fax Number : 225-927-5096
Provider Business Practice Location Address
First Line : 748 CHEVELLE DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6503
Country : US
Telephone Number : 225-927-5095
Fax Number : 225-927-5096
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. MADELINE B HOLDER
Credential :
Telephone Number : 225-927-5095
Provider Enumeration Date : 06/05/2008
Last Update Date : 06/05/2008

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Directions to “ED BATEMAN DDS A PROFESSIONAL DENTAL CORPORATION ” Practice Location

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