Provider Demographics
NPI:1497976070
Name:KATES, DALE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:A
Last Name:KATES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 SEVERANCE CIR STE 714
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1590
Mailing Address - Country:US
Mailing Address - Phone:216-691-9944
Mailing Address - Fax:216-691-9949
Practice Address - Street 1:5 SEVERANCE CIR STE 714
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1590
Practice Address - Country:US
Practice Address - Phone:216-691-9944
Practice Address - Fax:216-691-9949
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH198301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics