Individual
DR. SHAVON TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2555 N DR MARTIN LUTHER KING JR DR, MILWAUKEE, WI 53212-2709
(414) 267-2670
(414) 562-8432
Mailing address
2555 N DR MARTIN LUTHER KING JR DR, MILWAUKEE, WI 53212-2709
(414) 267-2670
(414) 562-8432
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2024022265
MO
122300000X
Dentist
Primary
6001651-15
WI
1223G0001X
General Practice Dentistry
6001651-15
WI
Other
Enumeration date
06/17/2024
Last updated
07/17/2025
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