Individual
JAMES L GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1128 N MAIN ST, SUITE A, MARION, VA 24354-4299
(276) 783-6818
(276) 783-2263
Mailing address
1128 N MAIN ST, SUITE A, MARION, VA 24354-4299
(276) 783-6818
(276) 783-2263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005722
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007822103
—
VA
01
—
141620
ANTHEM PROVIDER ID
VA
01
—
598414
UNITIED CONCORDIA
VA
Enumeration date
07/11/2006
Last updated
12/10/2015
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