Organization
DREW BANNERMAN DDS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN DREW BANNERMAN DDS (PRESIDENT)
(501) 256-4256
Entity
Organization
Contact information
Practice address
4603 FAIRWAY AVE, NORTH LITTLE ROCK, AR 72116-8052
(501) 771-7744
Mailing address
13 HERITAGE PARK CIR, NORTH LITTLE ROCK, AR 72116-8528
(501) 256-4256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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