Individual provider · NPI-1

Dr. Gwenna Natasha Bates, D.M.D.

Dentist, General Practice · Somerset, KY

NPI number1639188477
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1639188477
Entity type
Individual (NPI-1)
Name
Dr. Gwenna Natasha Bates
Credential
D.M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Aug 7, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice7394KYYes

Practice location

29 Eury Ln
Somerset, KY 42501-4115

Phone 606-678-8881 · Fax 606-678-8881

Mailing address

29 Eury Ln
Somerset, KY 42501-4115

Phone 606-678-8881 · Fax 606-678-8881

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