Provider Demographics
NPI:1245202886
Name:BUEKER, MARK STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:STEVEN
Last Name:BUEKER
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 1:116 COLINGTON LN
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-8057
Mailing Address - Country:US
Mailing Address - Phone:252-441-4696
Mailing Address - Fax:252-441-2233
Practice Address - Street 1:3118 N CROATAN HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:KILL DEVIL HILLS
Practice Address - State:NC
Practice Address - Zip Code:27948-9254
Practice Address - Country:US
Practice Address - Phone:252-441-5811
Practice Address - Fax:252-441-2233
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC54341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice