Individual
DR. ELIZABETH BANISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4 MEDICAL LN, CONWAY, AR 72034-4913
(501) 329-5205
Mailing address
4 MEDICAL LN, CONWAY, AR 72034-4913
(501) 329-5205
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4610
AR
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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