Individual
DR. CAROYLN COUSINS BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
35 E KEMPER RD, CINCINNATI, OH 45246-3224
(513) 642-0002
(513) 551-5017
Mailing address
35 E KEMPER RD, CINCINNATI, OH 45246-3224
(513) 642-0002
(513) 551-5017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30. 017027
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001928
ASSURANT
OH
05
—
0479138
—
OH
01
—
113300
AETNA DMO
OH
01
—
300056109
CARESOURCE
OH
Enumeration date
11/20/2006
Last updated
12/07/2016
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