Provider Demographics
NPI:1942037908
Name:BANCHS, LUCA ALEXUIS (DMD)
Entity type:Individual
Prefix:
First Name:LUCA
Middle Name:ALEXUIS
Last Name:BANCHS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W MISSION BLVD UNIT 206
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1382
Mailing Address - Country:US
Mailing Address - Phone:716-361-7858
Mailing Address - Fax:
Practice Address - Street 1:1300 W MISSION BLVD UNIT 206
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-1382
Practice Address - Country:US
Practice Address - Phone:716-361-7858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program