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Individual

DR. KEVIN MICHAEL BANKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
57 THOMAS JOHNSON DR STE A, FREDERICK, MD 21702-4670
(301) 404-1665
Mailing address
57 THOMAS JOHNSON DR STE A, FREDERICK, MD 21702-4670
(301) 404-1665

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
15292
MD
1223P0221X
Pediatric Dentistry
Primary
15292
MD

Other

Enumeration date
09/06/2012
Last updated
07/22/2015
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