Provider Demographics
NPI:1811149065
Name:ALLCARE DENTAL & DENTURES OF ND PC
Entity type:Organization
Organization Name:ALLCARE DENTAL & DENTURES OF ND PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-622-1563
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14231-0316
Mailing Address - Country:US
Mailing Address - Phone:716-204-4999
Mailing Address - Fax:716-632-7966
Practice Address - Street 1:4302 13TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3395
Practice Address - Country:US
Practice Address - Phone:701-277-3269
Practice Address - Fax:701-277-4994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLCARE DENTAL & DENTURES OF ND PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty