Healthcare Provider Details

I. General information

NPI: 1790423846
Provider Name (Legal Business Name): TURTLE DENTAL MANAGEMENT PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 E MARYLAND AVE STE 2
PHOENIX AZ
85014-1417
US

IV. Provider business mailing address

1550 E MARYLAND AVE STE 2
PHOENIX AZ
85014-1417
US

V. Phone/Fax

Practice location:
  • Phone: 602-285-9979
  • Fax:
Mailing address:
  • Phone: 602-285-9979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTIN A JONES
Title or Position: OWNER/PRESIDENT
Credential: DMD
Phone: 602-285-9979