MEDICARE: ALLCARE DENTAL & DENTURES OF OHIO - BATES

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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1669642153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLCARE DENTAL & DENTURES OF OHIO - BATES

Provider Business Mailing Address
First Line	:	PO BOX 369
Second Line	:
City	:	CLARENCE
State	:	NY
Zip	:	14031-0369
Country	:	US
Telephone Number	:	716-204-4999
Fax Number	:	716-632-2963

Provider Business Practice Location Address
First Line	:	2293 WALKER LAKE RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44903-6519
Country	:	US
Telephone Number	:	419-747-3365
Fax Number	:	419-747-5153

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT S BATES
Credential	:	DDS
Telephone Number	:	716-622-1563

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	03/11/2008

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