MEDICARE: KATHELENE WILLIAMS-TURK D.D.S.

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	1223G0001X	General Practice Dentistry	DD5221	NM
2	1223G0001X	General Practice Dentistry	40041	CA

General Provider Information

NPI Number	:	1205844875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHELENE WILLIAMS-TURK D.D.S.

Provider Business Mailing Address
First Line	:	1235 8TH ST
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4219
Country	:	US
Telephone Number	:	805-688-9821
Fax Number	:	805-688-3426

Provider Business Practice Location Address
First Line	:	2900 NOJOQUI AVE
Second Line	:
City	:	LOS OLIVOS
State	:	CA
Zip	:	93441
Country	:	US
Telephone Number	:	805-688-9821
Fax Number	:	805-688-3426

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	10/08/2019

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Directions to “ KATHELENE WILLIAMS-TURK D.D.S.” Practice Location

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