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NPI Code Detail

MEDICARE: DR. LUKE ALLEN FOSTER DDS

MEDICARE:  DR. LUKE ALLEN FOSTER  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry6018WI
21223G0001XGeneral Practice DentistryD12768MN

General Provider Information

NPI Number : 1982733341
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUKE ALLEN FOSTER DDS
Provider Business Mailing Address
First Line : 4045 BROOKSIDE AVE
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-2808
Country : US
Telephone Number : 319-331-8999
Fax Number :
Provider Business Practice Location Address
First Line : 4045 BROOKSIDE AVE
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-2808
Country : US
Telephone Number : 952-924-0709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2007
Last Update Date : 04/24/2012

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Directions to “ DR. LUKE ALLEN FOSTER DDS” Practice Location

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