Banasik, P Michael
Banasik, P Michael is an individual health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Banasik, P Michael can be contacted via phone (608) 782-7300.Contact Information
Primary practice address
1836 South Ave
La Crosse WI 54601-5429
Phone: (608) 782-7300
Fax: (608) 775-4467
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 5000273 | Wisconsin |
Profile Details
| NPI number | 1932103900 |
|---|---|
| LBN Legal business name | Banasik, P Michael |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932103900 | NPPES |
| Wisconsin | MEDICAID | 33663300 |
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