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Organization
BANTY DENTAL CORPORATION
Active
Organization
BANTY DENTAL CORPORATION
Active
Other names
SoLA Kids Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA BANTY DMD (PRESIDENT)
(843) 557-4335
Entity
Organization
Contact information
Practice address
5971 S MAIN STREET, LOS ANGELES, CA 90003
(323) 325-5641
Mailing address
387 W CHANNEL RD, SANTA MONICA, CA 90402-1107
(843) 557-4335
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DDS100420
CA
Other
Enumeration date
08/13/2018
Last updated
09/30/2018
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