Healthcare Provider Details

I. General information

NPI: 1427199397
Provider Name (Legal Business Name): PATRICK K TURLEY DDS MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14650 AVIATION BLVD SUITE 220
HAWTHORNE CA
90250-6656
US

IV. Provider business mailing address

3104 THE STRAND
MANHATTAN BEACH CA
90266-3953
US

V. Phone/Fax

Practice location:
  • Phone: 310-546-5097
  • Fax: 310-546-5097
Mailing address:
  • Phone: 310-546-5097
  • Fax: 310-546-5097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number25038
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: