Orthodontic Associates of Columbia and Waterloo

NPI #1295153641 in Columbia, Illinois

Provider Information

NPI Number: 1295153641
Entity Type: Organization
Organization Name: Orthodontic Associates of Columbia and Waterloo
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Apr 2, 2014
Last Updated: Apr 2, 2014

Practice Location

Address: 1060 ADMIRAL WEINEL BLVD
City: Columbia
State: Illinois
ZIP Code: 62236-1988
Phone: (618) 281-3399

Authorized Official

Name: DR. BRENT DEE BANKHEAD, DDS, MS
Title: DR.
Phone: (618) 281-3399

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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