Provider Demographics
NPI:1477953446
Name:BANH, ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:BANH
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 1:11317 CHERRYLEE DR
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-1008
Mailing Address - Country:US
Mailing Address - Phone:626-347-3206
Mailing Address - Fax:
Practice Address - Street 1:11416 N FM 620
Practice Address - Street 2:SUITE K
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-1161
Practice Address - Country:US
Practice Address - Phone:626-347-3206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300961223G0001X
CA634501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice