MEDICARE: MR. DAVID G. TURTZO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DSO17492L	PA

General Provider Information

NPI Number	:	1033174065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID G. TURTZO D.D.S.

Provider Business Mailing Address
First Line	:	101 S SCHANCK AVE
Second Line	:
City	:	PEN ARGYL
State	:	PA
Zip	:	18072-1697
Country	:	US
Telephone Number	:	610-863-4424
Fax Number	:	610-863-6341

Provider Business Practice Location Address
First Line	:	101 S SCHANCK AVE
Second Line	:
City	:	PEN ARGYL
State	:	PA
Zip	:	18072-1697
Country	:	US
Telephone Number	:	610-863-4424
Fax Number	:	610-863-6341

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	07/09/2007

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Practice Location Address:

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