Provider Demographics
NPI:1609974328
Name:BATES, ROBERT S (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:BATES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14231
Mailing Address - Country:US
Mailing Address - Phone:716-204-9836
Mailing Address - Fax:716-632-7966
Practice Address - Street 1:1740 WALDEN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225
Practice Address - Country:US
Practice Address - Phone:716-332-3026
Practice Address - Fax:716-332-2146
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046156-1122300000X
MI2901019275122300000X
NH03515122300000X
IN12010806A122300000X
OH30-021538122300000X
PAD5031602L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist