Healthcare Provider Details

I. General information

NPI: 1063430312
Provider Name (Legal Business Name): ERWIN G TURNER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A-218 KENTUCKY CLINIC
LEXINGTON KY
40536-0284
US

IV. Provider business mailing address

A-218 KENTUCKY CLINIC
LEXINGTON KY
40536-0284
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-3119
  • Fax: 859-323-2036
Mailing address:
  • Phone: 859-323-3119
  • Fax: 859-323-2036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number4366
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: