Provider Demographics
NPI:1932540234
Name:BATES DENTAL, PS
Entity Type:Organization
Organization Name:BATES DENTAL, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BRADY
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-795-5878
Mailing Address - Street 1:2700 S SOUTHEAST BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4984
Mailing Address - Country:US
Mailing Address - Phone:509-795-5878
Mailing Address - Fax:509-383-4199
Practice Address - Street 1:2700 S SOUTHEAST BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4984
Practice Address - Country:US
Practice Address - Phone:509-795-5878
Practice Address - Fax:509-383-4199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602903491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty