Individual
CARLEY BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.D.T
Contact information
Practice address
1575 20TH ST NW, FARIBAULT, MN 55021
(507) 334-6433
Mailing address
1575 20TH ST NW, STE 102, FARIBAULT, MN 55021-2930
(507) 334-6433
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
DT17
MN
Other
Enumeration date
04/10/2017
Last updated
07/24/2018
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