Individual
DR. MARK WALTER WICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
803 HIGHWAY #71 WEST, SAVANNAH, MO 64485-1151
(816) 324-5644
(816) 324-6307
Mailing address
803 HIGHWAY #71 WEST, SAVANNAH, MO 64485-1151
(816) 324-5644
(816) 324-6307
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
012833
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861697559
—
MO
01
—
28276
BNDD
MO
Enumeration date
06/20/2007
Last updated
03/07/2023
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