Healthcare Provider Details

I. General information

NPI: 1750620076
Provider Name (Legal Business Name): OLAIFA V TURNER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2013
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 E WASHINGTON AVE
MADISON WI
53704-4301
US

IV. Provider business mailing address

4 COMMERCE LN
CANTON NY
13617-3739
US

V. Phone/Fax

Practice location:
  • Phone: 888-988-4066
  • Fax:
Mailing address:
  • Phone: 315-386-8191
  • Fax: 315-386-1410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD11930
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN21558
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD11930
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: