| Susan Kay Banta Dds Ms Pa | |
|
1611 Doctors Circle Wilmington NC 28401 | |
| (910) 772-9770 | |
| (910) 772-1553 |
| Full Name | Susan Kay Banta Dds Ms Pa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1611 Doctors Circle, Wilmington, North Carolina |
| Authorized Official Name and Position | Susan Kay Banta (PRESIDENT) |
| Authorized Official Contact | 9107729770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Kay Banta Dds Ms Pa 1611 Doctors Circle Wilmington NC 28401 Ph: (910) 772-9770 | Susan Kay Banta Dds Ms Pa 1611 Doctors Circle Wilmington NC 28401 Ph: (910) 772-9770 |
| NPI Number | 1124181110 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 12/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124181110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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