Individual
DR. CHARLES JOSEPH BANASKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1440 W MANCHESTER AVE, LOS ANGELES, CA 90047-5422
(323) 753-1141
Mailing address
1549 PALOS VERDES DR W, PALOS VERDES ESTATES, CA 90274-1846
(310) 378-4646
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22468
CA
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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