Provider Demographics
NPI:1427498880
Name:OATES, ERIC JEROME (DDS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JEROME
Last Name:OATES
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 1:424 EDENCREST CT
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1918
Mailing Address - Country:US
Mailing Address - Phone:919-598-1180
Mailing Address - Fax:
Practice Address - Street 1:424 EDENCREST CT
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-1918
Practice Address - Country:US
Practice Address - Phone:919-598-1180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist