Healthcare Provider Details

I. General information

NPI: 1003252685
Provider Name (Legal Business Name): MARK EDWARD TURNER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 NW FEDERAL HWY SUITE A-110
STUART FL
34994-9314
US

IV. Provider business mailing address

197 CROSS ST
BRONX NY
10464-1225
US

V. Phone/Fax

Practice location:
  • Phone: 772-692-4002
  • Fax:
Mailing address:
  • Phone: 845-596-8242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22422
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: