Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 12362 | NC |
NPI | 1043985179 |
---|---|
Provider Name | Dr. Caroline Bates |
First Address | Lexington, NC 27295-9732 |
Second Address | Winston Salem, NC 27103-4016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2021 |
Last Update Date | 11/08/2021 |