Individual
LUKE ISAAC BANCHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7710 BROOKLYN BLVD, BROOKLYN PARK, MN 55443-2979
(651) 292-9331
Mailing address
7710 BROOKLYN BLVD, BROOKLYN PARK, MN 55443-2979
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D15024
MN
Other
Enumeration date
12/19/2023
Last updated
12/19/2023
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