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Individual
DR. DEREK L BATES
Active
Individual
DR. DEREK L BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D14268
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
74920
MN
Other
Enumeration date
08/08/2019
Last updated
08/01/2023
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