MEDICARE: RICHARD W. BATES DDS

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	6386	VA

General Provider Information

NPI Number	:	1851583116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD W. BATES DDS

Provider Business Mailing Address
First Line	:	3610 BOULEVARD
Second Line	:	SUITE A
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1329
Country	:	US
Telephone Number	:	804-526-0937
Fax Number	:	804-520-7582

Provider Business Practice Location Address
First Line	:	3610 BOULEVARD
Second Line	:	SUITE A
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1329
Country	:	US
Telephone Number	:	804-526-0937
Fax Number	:	804-520-7582

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. RICHARD W BATES
Credential	:	DDS
Telephone Number	:	804-526-0937

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	08/10/2007

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