Individual
DR. KENNETH BANASIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
65 SOUTH MAPLE AVE, BASKING RIDGE, NJ 07920
(908) 766-2444
(908) 221-9655
Mailing address
65 SOUTH MAPLE AVE, BASKING RIDGE, NJ 07920
(908) 766-2444
(908) 221-9655
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02217600
NJ
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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