Provider Demographics
NPI:1013079425
Name:MARKS, DAVID O (DDS, INC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:O
Last Name:MARKS
Suffix:
Gender:M
Credentials:DDS, INC
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:O
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS INC
Mailing Address - Street 1:6565 S. YALE AVE
Mailing Address - Street 2:#1101
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8346
Mailing Address - Country:US
Mailing Address - Phone:918-481-4900
Mailing Address - Fax:918-481-4906
Practice Address - Street 1:6565 S. YALE AVE
Practice Address - Street 2:#1101
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8346
Practice Address - Country:US
Practice Address - Phone:918-481-4900
Practice Address - Fax:918-481-4906
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK30871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice