Individual
MACKENZIE BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
11600 BUSY ST STE 101, NORTH CHESTERFIELD, VA 23236-4066
(804) 215-8600
Mailing address
11600 BUSY ST STE 101, NORTH CHESTERFIELD, VA 23236-4066
(804) 215-8600
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401417495
VA
Other
Enumeration date
05/18/2021
Last updated
10/10/2023
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