Individual
DR. ANDREW R BANKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
2250 HOSPITAL DR, SUITE 132, BOSSIER CITY, LA 71111-2167
(318) 747-5812
(318) 747-5841
Mailing address
2250 HOSPITAL DR, SUITE 132, BOSSIER CITY, LA 71111-2167
(318) 747-5812
(318) 747-5841
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
6203
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09336
—
LA
05
—
1093360
—
LA
Enumeration date
05/23/2007
Last updated
03/09/2012
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