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Individual
JAMES L GATES
Active
Individual
JAMES L GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005722
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007822103
—
VA
01
—
141620
ANTHEM PROVIDER ID
VA
01
—
598414
UNITIED CONCORDIA
VA
Enumeration date
07/11/2006
Last updated
12/10/2015
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