Provider Demographics
NPI:1376677443
Name:BATES, DELOSS CLARE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DELOSS
Middle Name:CLARE
Last Name:BATES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1125 MICHIGAN AVE E STE 7
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-6832
Mailing Address - Country:US
Mailing Address - Phone:269-963-7861
Mailing Address - Fax:269-963-0579
Practice Address - Street 1:1125 MICHIGAN AVE E STE 7
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-6832
Practice Address - Country:US
Practice Address - Phone:269-963-7861
Practice Address - Fax:269-963-0579
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI84501223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry