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BUCCA DENTAL LLC
NPI 1750774428
Clinic/Center - Dental in Minneapolis, MN

Active since March 05, 2015
1508 E LAKE ST, MINNEAPOLIS, MN 55407(612) 724-1717(612) 724-3114 Get Directions Write a Review

NPPES record last updated: March 5, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bucca Dental Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BUCCA DENTAL LLC (NPI 1750774428) is a healthcare organization registered as a dental in Minneapolis, Minnesota and active in the NPI registry since March 2015. The organization lists Edgar Fernando Mantilla, Ceo, as its authorized official.

NPPES Registry Identity

NPI1750774428
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameBUCCA DENTAL LLC
Location Address1508 E LAKE STMinneapolis, MN 55407-1720
Mailing Address1508 E Lake StMinneapolis, MN 55407-1720 · (612) 724-1717 · Fax (612) 724-3114
Phone(612) 724-1717
Fax(612) 724-3114
Organization SubpartNo
Authorized OfficialEdgar Fernando MantillaCeo · (612) 724-1717
Enumeration DateMarch 5, 2015
✔ NPI 1750774428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in MN · D11889
1508 E LAKE ST, Minneapolis, MN 55407
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKE STREET DENTAL
Dentist (Prosthodontics)
1508 E LAKE ST
MINNEAPOLIS, MN 55407
Hennepin County (612) 724-1717

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bucca Dental LLC's NPI number?

The NPI number for Bucca Dental LLC is 1750774428. It was assigned to this organization in the NPPES registry on March 5, 2015.

Where is Bucca Dental LLC located?

Bucca Dental LLC is located at 1508 E Lake St, Minneapolis, MN 55407. The listed phone number is (612) 724-1717.

What is Bucca Dental LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Bucca Dental LLC was last updated on March 5, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.