Provider Demographics
NPI:1689725749
Name:HAUSER, MARK J (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:HAUSER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:1065 JOHNNIE DODDS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6153
Mailing Address - Country:US
Mailing Address - Phone:843-849-7787
Mailing Address - Fax:843-849-7678
Practice Address - Street 1:1065 JOHNNIE DODDS BLVD STE B
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6153
Practice Address - Country:US
Practice Address - Phone:843-849-7787
Practice Address - Fax:843-849-7678
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC04461223E0200X
VA04010073191223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics