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Individual

LESLY Y BANOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
7310 WALTON ST, ROCKFORD, IL 61108-4614
(815) 395-5555
Mailing address
4421 OLMSTEAD DR, HOFFMAN ESTATES, IL 60192-1141
(630) 229-7528

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.034334
IL

Other

Enumeration date
06/09/2023
Last updated
06/09/2023
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