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Individual
OLEG PROKOPENKO
Active
Individual
OLEG PROKOPENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DN 28013
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2024020971
MO
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN28013
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2018
Last updated
09/10/2026
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