Individual
TANNER BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
100 STARLITE DR, KINGFISHER, OK 73750-4944
(405) 375-5855
Mailing address
100 STARLITE DR, KINGFISHER, OK 73750-4944
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7865
OK
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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