Provider Demographics
NPI:1205269453
Name:BATEMAN, CAROLINE HAINES (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:HAINES
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4466 DARROW RD STE 16
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1891
Mailing Address - Country:US
Mailing Address - Phone:330-688-3115
Mailing Address - Fax:
Practice Address - Street 1:4466 DARROW RD STE 16
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1891
Practice Address - Country:US
Practice Address - Phone:330-688-3115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02546600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist