Healthcare Provider Details

I. General information

NPI: 1194888396
Provider Name (Legal Business Name): STEVEN JOHN TURNER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8027 S STATE RD
GOODRICH MI
48438-9700
US

IV. Provider business mailing address

PO BOX 327
GOODRICH MI
48438-0327
US

V. Phone/Fax

Practice location:
  • Phone: 810-636-2808
  • Fax: 810-636-4010
Mailing address:
  • Phone: 810-636-2808
  • Fax: 810-636-4010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901015107
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: