Provider Demographics
NPI:1821831769
Name:ROSS OATES DMD PLLC
Entity type:Organization
Organization Name:ROSS OATES DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:OATES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-299-7186
Mailing Address - Street 1:20 N GRAND AVENUE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075
Mailing Address - Country:US
Mailing Address - Phone:859-441-1900
Mailing Address - Fax:
Practice Address - Street 1:20 N GRAND AVENUE
Practice Address - Street 2:SUITE 10
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075
Practice Address - Country:US
Practice Address - Phone:859-441-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty