Provider Demographics
NPI:1972650497
Name:MARK L. YOUNGKER, DDS, MS, INC.
Entity Type:Organization
Organization Name:MARK L. YOUNGKER, DDS, MS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:YOUNGKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:405-634-4700
Mailing Address - Street 1:7421 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2009
Mailing Address - Country:US
Mailing Address - Phone:405-634-4700
Mailing Address - Fax:405-634-4747
Practice Address - Street 1:7421 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2009
Practice Address - Country:US
Practice Address - Phone:405-634-4700
Practice Address - Fax:405-634-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54504174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty