Provider Demographics
NPI:1023211968
Name:TURNER, HENRY JULIAN (DDS MSD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:JULIAN
Last Name:TURNER
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 STARR DRIVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2578
Mailing Address - Country:US
Mailing Address - Phone:706-226-6331
Mailing Address - Fax:706-226-6332
Practice Address - Street 1:1209 STARR DRIVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2578
Practice Address - Country:US
Practice Address - Phone:706-226-6331
Practice Address - Fax:706-226-6332
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0070011223S0112X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00048793AMedicaid
GAPIN19NCBNBMedicare ID - Type Unspecified
GA00048793AMedicaid