Brant D Banner, DDS Valid NPI
Individual provider · Dentist · Tumwater, WA
- NPI
- 1760405187
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- DE00004047 (WA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2006-07-26
- Last updated
- 2007-07-08
Practice location
6340 Littlerock Rd Sw
Tumwater, WA 98512-7332
(360) 786-1313