Healthcare Provider Details
I. General information
NPI: 1922368281
Provider Name (Legal Business Name): TURNAGE FAMILY DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2012
Last Update Date: 05/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
505 SPRINGRIDGE RD STE C
CLINTON MS
39056-5612
US
IV. Provider business mailing address
505 SPRINGRIDGE RD STE C
CLINTON MS
39056-5612
US
V. Phone/Fax
- Phone: 601-924-4494
- Fax:
- Phone: 601-924-4494
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | 3471 |
| License Number State | MS |
VIII. Authorized Official
Name: DR.
APRIL
A
TURNAGE
Title or Position: OWNER
Credential: D.M.D.
Phone: 601-924-4494