Provider Demographics
NPI:1386974798
Name:BATES, TIMOTHY JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSEPH
Last Name:BATES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 DENISON PKWY E
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2813
Mailing Address - Country:US
Mailing Address - Phone:607-937-5341
Mailing Address - Fax:607-937-5344
Practice Address - Street 1:218 DENISON PKWY E
Practice Address - Street 2:SUITE 1
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2813
Practice Address - Country:US
Practice Address - Phone:607-937-5341
Practice Address - Fax:607-937-5344
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0296101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice