Provider Demographics
NPI:1063548675
Name:MARK F. HESKER, D.D.S., P.C.
Entity type:Organization
Organization Name:MARK F. HESKER, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HESKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:314-569-3337
Mailing Address - Street 1:450 N NEW BALLAS RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6835
Mailing Address - Country:US
Mailing Address - Phone:314-569-3337
Mailing Address - Fax:314-569-1522
Practice Address - Street 1:450 N NEW BALLAS RD
Practice Address - Street 2:SUITE #200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6835
Practice Address - Country:US
Practice Address - Phone:314-569-3337
Practice Address - Fax:314-569-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0151321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty