Provider Demographics
NPI:1194842906
Name:SCHUELKE, MARK NORMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:NORMAN
Last Name:SCHUELKE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 S ABILENE ST
Mailing Address - Street 2:SUITE #135
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2300
Mailing Address - Country:US
Mailing Address - Phone:303-750-7990
Mailing Address - Fax:
Practice Address - Street 1:2675 S ABILENE ST
Practice Address - Street 2:SUITE #135
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2300
Practice Address - Country:US
Practice Address - Phone:303-750-7990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1043431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice