Organization
WENTZVILLE ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT DEE BANKHEAD DDS, MS (DOCTOR)
(636) 332-2350
Entity
Organization
Contact information
Practice address
1051 W PEARCE BLVD, WENTZVILLE, MO 63385-1019
(636) 332-2350
Mailing address
1051 W PEARCE BLVD, WENTZVILLE, MO 63385-1019
(636) 332-2350
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/19/2007
Last updated
08/04/2008
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