Individual
ANIMESH BANERJEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
W3216 COUNTY ROAD KK STE 107, APPLETON, WI 54915-9432
(920) 843-6004
Mailing address
903 S ASHLAND AVE APT 303, CHICAGO, IL 60607-4096
(360) 286-5258
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001922
WI
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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