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Individual

DR. MARK NOLAN STUCKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3550 BRIARFIELD BLVD, SUITE 100, MAUMEE, OH 43537-8916
(419) 866-6985
(419) 866-4311
Mailing address
3550 BRIARFIELD BLVD STE 100, MAUMEE, OH 43537-9184
(419) 866-6985
(419) 866-4311

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16965
OH
332B00000X
Durable Medical Equipment & Medical Supplies
16965
OH

Other

Enumeration date
07/31/2006
Last updated
06/18/2019
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