Provider Demographics
NPI:1215153739
Name:BATES AND MILLER, PLLC, DDS
Entity type:Organization
Organization Name:BATES AND MILLER, PLLC, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-276-8999
Mailing Address - Street 1:PO BOX 1988
Mailing Address - Street 2:20 E J STREET SUITE 2B
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-1988
Mailing Address - Country:US
Mailing Address - Phone:509-276-8999
Mailing Address - Fax:509-276-8899
Practice Address - Street 1:20 E J STREET
Practice Address - Street 2:SUITE 2B
Practice Address - City:DEER PARK
Practice Address - State:WA
Practice Address - Zip Code:99006
Practice Address - Country:US
Practice Address - Phone:509-276-8999
Practice Address - Fax:509-276-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental