Provider Demographics
NPI:1538763966
Name:BANT CORPORATION
Entity type:Organization
Organization Name:BANT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS, OWNER OF THE PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-753-5419
Mailing Address - Street 1:4115 WILKENS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-4750
Mailing Address - Country:US
Mailing Address - Phone:410-737-9666
Mailing Address - Fax:410-565-6084
Practice Address - Street 1:4115 WILKENS AVE STE 100
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-4750
Practice Address - Country:US
Practice Address - Phone:410-737-9666
Practice Address - Fax:410-565-6084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental