IndividualActive
Mark Balenseifen, D.D.S.
NPI 1366500142 · Prosthodontics · Yukon, OK
Provider details
- NPI number
- 1366500142
- Entity type
- Individual
- Primary specialty
- ProsthodonticsDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 5210 (OK)
Specialties & taxonomies
Dental Providers
Practice location
415 E Main St Ste 4
Yukon, OK 73099-2259
Phone: (405) 467-4092
Fax: (405) 467-4429
Approximate (ZIP-level) locationGet directions
Mailing address
415 E Main St Ste 4
Yukon, OK 73099-2259
Registry dates
- Enumerated
- 2006-12-05
- Last updated
- 2024-03-26
- Certified
- 2024-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.