Provider Demographics
NPI:1033105317
Name:TURGESEN, PAUL D (DMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:TURGESEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 MONMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97351-1126
Mailing Address - Country:US
Mailing Address - Phone:503-838-5051
Mailing Address - Fax:503-838-0188
Practice Address - Street 1:1335 MONMOUTH ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OR
Practice Address - Zip Code:97351-1126
Practice Address - Country:US
Practice Address - Phone:503-838-5051
Practice Address - Fax:503-838-0188
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD57991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice