Alexander Bannout, DDS

NPI #1255419446 in Pooler, Georgia

Provider Information

NPI Number: 1255419446
Entity Type: Individual
Name: Alexander Bannout, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Nov 2, 2006
Last Updated: Sep 24, 2010

Practice Location

Address: 130 CANAL ST
Address 2: SUITE 204
City: Pooler
State: Georgia
ZIP Code: 31322-4085
Phone: (912) 748-5868

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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