Individual
STACIE A BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, EP
Contact information
Practice address
1321 ZINFANDEL LN, EUGENE, OR 97404-3873
(541) 914-9027
Mailing address
1321 ZINFANDEL LN, EUGENE, OR 97404-3873
(541) 914-9027
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H2616
OR
Other
Enumeration date
11/14/2014
Last updated
11/14/2014
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