Provider Demographics
NPI:1508074055
Name:BANKS, MARGUERITE ELLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARGUERITE
Middle Name:ELLEN
Last Name:BANKS
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 1:1240 LAKE FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1016
Mailing Address - Country:US
Mailing Address - Phone:410-377-3035
Mailing Address - Fax:
Practice Address - Street 1:7573 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3716
Practice Address - Country:US
Practice Address - Phone:410-761-2499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08366122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist