Jack William Balenseifen DDS, MS.

NPI 1053485433 - Dentist - 1223X0400X

NPI Details
NPI 1053485433
Gender Male
Enumeration Date 11/20/2006
Last Updated 07/09/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
7505 NW 23RD ST
BETHANY OK, 73008-4941, US
Phone (405) 789-6772
Fax (405) 789-6787
Business Location
7505 NW 23RD ST
BETHANY OK, 73008-4941, US
Phone (405) 789-6772
Fax (405) 789-6787
Toxanomy
Taxonomy Code 1223X0400X
License State Oklahoma
License Number 3042
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According to our database, Dr. Jack William Balenseifen DDS, MS. NPI is 1053485433, taxonomy code is 1223X0400X and license number is 3042, license state is located at Oklahoma. Jack William Balenseifen DDS, MS. physically located at 7505 Nw 23rd St, Bethany OK, 73008-4941. NPI Number Jack William Balenseifen DDS, MS. has the Individual type.

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1053485433 NPI number is provided on an as is basis without warranty of any kind. 1053485433 is maintained by the National Plan & Provider Enumeration System. The contents of Jack William Balenseifen DDS, MS. are for informational purposes only.