Healthcare Provider Details

I. General information

NPI: 1982937785
Provider Name (Legal Business Name): PORTIA DENISE TURNER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2009
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST BOX 19
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1000 W CARSON ST BOX 19
TORRANCE CA
90502-2004
US

V. Phone/Fax

Practice location:
  • Phone: 310-668-4676
  • Fax: 310-884-3263
Mailing address:
  • Phone: 310-668-4676
  • Fax: 310-884-3263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number35036
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: