Organization
BANTY DENTAL CORPORATION
Active
Other names
SoLA Kids Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA BANTY DMD (PRESIDENT)
(843) 557-4335
Entity
Organization
Contact information
Practice address
5971 S MAIN STREET, LOS ANGELES, CA 90003
(323) 325-5641
Mailing address
387 W CHANNEL RD, SANTA MONICA, CA 90402-1107
(843) 557-4335
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DDS100420
CA
Other
Enumeration date
08/13/2018
Last updated
09/30/2018
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