Provider Demographics
NPI:1376753897
Name:BANES, ANN CHURCHILL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:CHURCHILL
Last Name:BANES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WILLOW DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7078
Mailing Address - Country:US
Mailing Address - Phone:919-967-2472
Mailing Address - Fax:919-967-2578
Practice Address - Street 1:901 WILLOW DR
Practice Address - Street 2:SUITE 4
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7078
Practice Address - Country:US
Practice Address - Phone:919-967-2472
Practice Address - Fax:919-967-2578
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4317122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist