Provider Demographics
NPI:1679787402
Name:HOWARD A. BATES, D.M.D
Entity type:Organization
Organization Name:HOWARD A. BATES, D.M.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-621-0099
Mailing Address - Street 1:6 LEXINGTON LANE
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-5930
Mailing Address - Country:US
Mailing Address - Phone:207-621-0099
Mailing Address - Fax:207-621-0030
Practice Address - Street 1:221 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5930
Practice Address - Country:US
Practice Address - Phone:207-621-0099
Practice Address - Fax:207-621-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME$$$$$$$$$OtherSOCIAL SECURITY NUMBER
ME1215035100OtherNPI #1