Provider Demographics
NPI:1043642861
Name:BANKS, DANIEL WAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WAYNE
Last Name:BANKS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 WATER VALLEY PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-6264
Mailing Address - Country:US
Mailing Address - Phone:970-460-8989
Mailing Address - Fax:970-460-8989
Practice Address - Street 1:1349 WATER VALLEY PKWY STE 101
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-6264
Practice Address - Country:US
Practice Address - Phone:970-460-8989
Practice Address - Fax:970-460-8989
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN00202043122300000X
WI1001770-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist