MEDICARE: D JENSEN TURNER DMD LLC

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	1223P0221X	Pediatric Dentistry	780	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902323868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D JENSEN TURNER DMD LLC

Provider Business Mailing Address
First Line	:	365 E BLACKSTOCK RD STE B
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29301-3762
Country	:	US
Telephone Number	:	864-574-4287
Fax Number	:	864-574-4118

Provider Business Practice Location Address
First Line	:	365 E BLACKSTOCK RD STE B
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29301-3762
Country	:	US
Telephone Number	:	864-574-4287
Fax Number	:	864-574-4118

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONALD JENSEN TURNER
Credential	:	DMD
Telephone Number	:	864-209-9767

Provider Enumeration Date	:	08/23/2017
Last Update Date	:	07/21/2022

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