Provider Demographics
NPI:1679660047
Name:SCHESKE, MICHAEL CARL (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CARL
Last Name:SCHESKE
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 1:301 WEST HWY 50
Mailing Address - Street 2:STE C
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084
Mailing Address - Country:US
Mailing Address - Phone:636-583-8100
Mailing Address - Fax:636-583-6534
Practice Address - Street 1:301 WEST HWY 50
Practice Address - Street 2:STE C
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084
Practice Address - Country:US
Practice Address - Phone:636-583-8100
Practice Address - Fax:636-583-6534
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO14746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist