Dr. Brent Dee Bankhead, DDS, MS
Dentist, Orthodontics and Dentofacial Orthopedics in O Fallon, MO. Individual provider (NPI-1).
NPI number1609917905
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1609917905
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brent Dee Bankhead
- Credential
- DDS, MS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 9, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 015876 | MO | Yes |
Practice location
2990 Highway KO Fallon, MO 63368-7861
Phone 636-978-4484 · Fax 636-978-0240
Mailing address
12101 Sutton Place CtSaint Louis, MO 63128-2180
Phone 314-843-0439 · Fax 636-978-0240
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