Provider Demographics
NPI:1124571559
Name:BANKS, TAYLOR ANDREW (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:ANDREW
Last Name:BANKS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CREST DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5324
Mailing Address - Country:US
Mailing Address - Phone:205-902-5573
Mailing Address - Fax:
Practice Address - Street 1:1901 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1626
Practice Address - Country:US
Practice Address - Phone:334-265-9202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6428122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist