Provider Demographics
NPI:1962829226
Name:GERTRUDES C. BATTE, DDS DENTAL CORPORATION
Entity Type:Organization
Organization Name:GERTRUDES C. BATTE, DDS DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERTRUDES
Authorized Official - Middle Name:CHED
Authorized Official - Last Name:BATTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-541-9909
Mailing Address - Street 1:1714 E MCFADDEN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4603
Mailing Address - Country:US
Mailing Address - Phone:714-541-9909
Mailing Address - Fax:
Practice Address - Street 1:1714 E MCFADDEN AVE STE C
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4603
Practice Address - Country:US
Practice Address - Phone:714-541-9909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39231122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty