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1932103900
P MICHAEL BANASIK
LA CROSSE, WI
NPI
1932103900
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: WI 5000273)
Enumeration Date
2005-06-08
Last Update Date
2007-07-08
Business Address
-- P MICHAEL BANASIK DDS
1836 SOUTH AVE
LA CROSSE, WI 54601-5429
Phone number: 608-782-7300
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Mailing Address
-- P MICHAEL BANASIK DDS
1836 SOUTH AVE
LA CROSSE, WI 54601-5429
Phone number: 608-782-7300
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