Individual
TROY BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2859 E FOUNTAIN BLVD, COLORADO SPRINGS, CO 80910-2312
(719) 442-0071
Mailing address
415 N GRAND AVE, PUEBLO, CO 81003-3111
(719) 546-3333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN-8450
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1622270
UNITED CONCORDIA
CO
05
—
27857034
—
CO
Enumeration date
10/11/2006
Last updated
07/09/2007
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