Provider Demographics
NPI:1669782066
Name:BANKS, RISHARD MEKEL (DDS)
Entity type:Individual
Prefix:DR
First Name:RISHARD
Middle Name:MEKEL
Last Name:BANKS
Suffix:
Gender:
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:BLDG 25501 BRAINARD AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30905
Mailing Address - Country:US
Mailing Address - Phone:706-787-4466
Mailing Address - Fax:
Practice Address - Street 1:SNYDER DENTAL CLINIC
Practice Address - Street 2:BLDG 25501 BRAINARD AVE
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905
Practice Address - Country:US
Practice Address - Phone:706-787-4466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAD6133122300000X
WADE61389604122300000X, 1223G0001X
MD14714122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice