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Individual

JENNIFER BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1120 15TH ST # GC5119, AUGUSTA, GA 30912-0004
(706) 721-2251
Mailing address
1120 15TH ST # GC5119, AUGUSTA, GA 30912-0004
(706) 721-2251

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
DN015860
GA

Other

Enumeration date
03/31/2019
Last updated
07/08/2019
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