Individual
DR. LUKE GUSTAVE SISKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14990 GLAZIER AVE, #100, APPLE VALLEY, MN 55124-7818
(952) 431-5114
(952) 431-3576
Mailing address
1248 PIONEER LN, SHAKOPEE, MN 55379-3463
(952) 496-3456
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10276
MN
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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