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General NPI Number Information
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NPI Number | 1063548675
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Entity Type | Organization
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Legal Business Name | MARK F. HESKER, D.D.S., P.C.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 450 N NEW BALLAS RD SUITE #200
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6835
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Country | US
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Telephone | 314-569-3337
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Fax | 314-569-1522
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Provider Business Mailing Address
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Address Line | 450 N NEW BALLAS RD SUITE #200
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6835
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Country | US
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Telephone | 314-569-3337
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Fax | 314-569-1522
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK HESKER
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Credential | DDS
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Telephone | 314-569-3337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 015132
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License Number State | MO
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