MEDICARE: AMY CHRISTINE TURNER-IANNACCI

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	30-019898	OH

General Provider Information

NPI Number	:	1922132968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY CHRISTINE TURNER-IANNACCI

Provider Business Mailing Address
First Line	:	415 N GRAND AVE
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-3111
Country	:	US
Telephone Number	:	719-583-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2830 COLERAIN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45225-2206
Country	:	US
Telephone Number	:	513-591-1400
Fax Number	:

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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