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Individual

DR. SHARON R. BANNISTER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
DDS,MS

Contact information

Practice address
2200 BERQUIST DRIVE, SUITE 1, ATTN: CREDENTIALS (CMC), LACKLAND AFB, TX 78236-5300
(210) 292-7269
Mailing address
2622 CENTURY RNCH, SAN ANTONIO, TX 78251-4939
(210) 292-7269

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
11718
MD
1223P0300X
Periodontics
30019865
OH

Other

Enumeration date
01/09/2006
Last updated
09/11/2025
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