Healthcare Provider Details

I. General information

NPI: 1184610057
Provider Name (Legal Business Name): PAIGE TURNER HOLBERT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. ELLISON PAIGE TURNER

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14001 CHARTER PARK DR.
MIDLOTHIAN VA
23114
US

IV. Provider business mailing address

1612 HUGUENOT RD
MIDLOTHIAN VA
23113
US

V. Phone/Fax

Practice location:
  • Phone: 804-379-1011
  • Fax: 804-417-0259
Mailing address:
  • Phone: 804-794-9789
  • Fax: 804-419-1059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number0401412283
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: