Provider Demographics
NPI:1285715722
Name:STANKEWITZ, MARK LEROY (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:LEROY
Last Name:STANKEWITZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:915 GESSNER RD
Mailing Address - Street 2:SUITE 515
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2527
Mailing Address - Country:US
Mailing Address - Phone:713-464-6335
Mailing Address - Fax:713-464-5589
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 515
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-464-6335
Practice Address - Fax:713-464-5589
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX139511223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics