Individual
HEATH TRIPP BATEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
395 E 600 S, PRESTON, ID 83263-4901
(208) 852-0194
Mailing address
2105 W 3600 S, WESTON, ID 83286-5162
(801) 851-0121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10858697-9922
UT
1223G0001X
General Practice Dentistry
Primary
D-5358
ID
Other
Enumeration date
06/11/2018
Last updated
03/17/2022
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