Provider Demographics
NPI:1780719922
Name:SHEKER, MARK LENIS (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:LENIS
Last Name:SHEKER
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 1:395 KRAFFT CT
Mailing Address - Street 2:
Mailing Address - City:NEKOOSA
Mailing Address - State:WI
Mailing Address - Zip Code:54457-7314
Mailing Address - Country:US
Mailing Address - Phone:715-886-2958
Mailing Address - Fax:
Practice Address - Street 1:395 KRAFFT CT
Practice Address - Street 2:
Practice Address - City:NEKOOSA
Practice Address - State:WI
Practice Address - Zip Code:54457-7314
Practice Address - Country:US
Practice Address - Phone:715-886-2958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5303-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice