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General NPI Number Information
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NPI Number | 1760544704
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Entity Type | Organization
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Legal Business Name | THOMAS W TURNBULL DDS PC
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1024 N SAN FRANCISCO ST SUITE 101
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City | FLAGSTAFF
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State | AZ
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Zip | 86001
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Country | US
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Telephone | 928-779-0385
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Fax | 928-779-6487
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Provider Business Mailing Address
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Address Line | 1024 N SAN FRANCISCO ST SUITE 101
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City | FLAGSTAFF
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State | AZ
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Zip | 86001
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Country | US
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Telephone | 928-779-0385
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Fax | 928-779-6487
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS WISHARD TURNBULL
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Credential | DDS
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Telephone | 928-779-0385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 07430154
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License Number State | AZ
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