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General NPI Number Information
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NPI Number | 1396925244
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Entity Type | Individual
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Provider Name | BRIAN ROBERT BANFIELD DMD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 3303 S LINDSAY RD STE 127
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City | GILBERT
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State | AZ
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Zip | 85297-2100
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Country | US
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Telephone | 480-699-2940
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Fax | 480-699-2941
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Provider Business Mailing Address
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Address Line | 3303 S. LINDSAY ROAD, #127
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City | GILBERT
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State | AZ
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Zip | 85297
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Country | US
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Telephone | 480-699-2940
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Fax | 480-699-2941
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 6826
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License Number State | AZ
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