| Michael Banawis Dds Professional Corporation | |
|
1745 Huntington Dr Duarte CA 91010-2551 | |
| (626) 357-9801 | |
| (626) 358-1706 |
| Full Name | Michael Banawis Dds Professional Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1745 Huntington Dr, Duarte, California |
| Authorized Official Name and Position | Michael B Banawis (DENTIST) |
| Authorized Official Contact | 6263579801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Banawis Dds Professional Corporation 1745 Huntington Dr Duarte CA 91010-2551 Ph: (626) 357-9801 | Michael Banawis Dds Professional Corporation 1745 Huntington Dr Duarte CA 91010-2551 Ph: (626) 357-9801 |
| NPI Number | 1366593097 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 07/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366593097 | NPI | - | NPPES |
| 523009 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 49278 (California) | Primary |
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