Individual
VINCEN BATEMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
42104 N VENTURE DR UNIT 103, ANTHEM, AZ 85086-3823
(480) 561-5693
Mailing address
2054 BALBOA DR, IDAHO FALLS, ID 83404-6457
(208) 680-4203
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D011800
AZ
Other
Enumeration date
06/29/2023
Last updated
11/04/2025
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