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Individual

KENNETH HOWARD BATEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
216 GREEN RIVER TRL, FORT WORTH, TX 76103-1038
(817) 691-8649
Mailing address
PO BOX 8426, FORT WORTH, TX 76124-0426
(817) 691-8649

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11052
TX

Other

Enumeration date
12/06/2007
Last updated
12/06/2007
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