MEDICARE: MARK L. YOUNGKER, DDS, MS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	54504	OK

General Provider Information

NPI Number	:	1972650497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK L. YOUNGKER, DDS, MS, INC.

Provider Business Mailing Address
First Line	:	7421 S WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2009
Country	:	US
Telephone Number	:	405-634-4700
Fax Number	:	405-634-4747

Provider Business Practice Location Address
First Line	:	7421 S WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2009
Country	:	US
Telephone Number	:	405-634-4700
Fax Number	:	405-634-4747

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	DR. MARK L. YOUNGKER
Credential	:	DDS, MS
Telephone Number	:	405-634-4700

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	08/22/2020

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