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Organization

ALEXANDER BANNOUT DDS, PC

Active
Other names
Parkway Center for Cosmetic Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALEXANDER BANNOUT DDS (DENTIST)
(248) 890-7347
Entity
Organization

Contact information

Practice address
130 CANAL ST, SUITE 204, POOLER, GA 31322-4085
(912) 748-5868
(912) 748-6778
Mailing address
130 CANAL ST, SUITE 204, POOLER, GA 31322-4085
(912) 748-5868
(912) 748-6778

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013382
GA

Other

Enumeration date
07/25/2010
Last updated
07/25/2010
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