Healthcare Provider Details

I. General information

NPI: 1841478815
Provider Name (Legal Business Name): SCOTT A TURIK DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N CORBETT AVE
KENLY NC
27542-0483
US

IV. Provider business mailing address

PO BOX 483 105 N CORBETT AVENUE
KENLY NC
27542-0483
US

V. Phone/Fax

Practice location:
  • Phone: 919-284-2254
  • Fax:
Mailing address:
  • Phone: 919-284-2254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5194
License Number StateNC

VIII. Authorized Official

Name: DR. SCOTT ALAN TURIK
Title or Position: PRESIDENT
Credential: DDS
Phone: 919-284-2254