Healthcare Provider Details

I. General information

NPI: 1306160148
Provider Name (Legal Business Name): DAVID T. TURBYFILL DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 N 9TH AVE STE 4
PENSACOLA FL
32503-2406
US

IV. Provider business mailing address

4850 N 9TH AVE STE 4
PENSACOLA FL
32503-2406
US

V. Phone/Fax

Practice location:
  • Phone: 850-477-1125
  • Fax: 850-479-5809
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN13469
License Number StateFL

VIII. Authorized Official

Name: MRS. LORI BROCK
Title or Position: MGR
Credential:
Phone: 850-477-1125