Individual ProviderTyler Joseph BanksDentistDental ProvidersPractice Address2665 Donaghey Ave Ste 112, Conway, AR 72032-2318(501) 450-7066(501) 680-5405PECOS EnrollmentBased on the most recent information from CMS, provider Tyler Joseph Banks does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1730921511Provider TypeIndividualFull NameBanks, Tyler JosephCredentialDMDGenderMaleSole ProprietorNoEnumeration Date6/11/2024Last Updated6/11/2024Contact InformationPractice LocationPractice Address2665 Donaghey Ave Ste 112, Conway, AR 72032-2318Phone(501) 450-7066FaxUnlisted FaxMailing LocationMailing Address2 Pinecrest Ln, Maumelle, AR 72113-6121Phone(501) 680-5405FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense4750Arkansas