Provider Demographics
NPI:1760898886
Name:BANAS, SAVANNAH L (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:L
Last Name:BANAS
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 1:26635 WOODWARD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1372
Mailing Address - Country:US
Mailing Address - Phone:248-398-6046
Mailing Address - Fax:
Practice Address - Street 1:26635 WOODWARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1372
Practice Address - Country:US
Practice Address - Phone:248-398-6046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010213081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice