Provider Demographics
NPI:1861985269
Name:SCHEMMEL, MARK ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:SCHEMMEL
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 1:3455 STONEMAN RD STE 4
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-5292
Mailing Address - Country:US
Mailing Address - Phone:563-556-0234
Mailing Address - Fax:563-556-0235
Practice Address - Street 1:3455 STONEMAN RD STE 4
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-5292
Practice Address - Country:US
Practice Address - Phone:563-556-0234
Practice Address - Fax:563-556-0235
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA095601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice