Provider Demographics
NPI:1033174065
Name:TURTZO, DAVID G (DDS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:G
Last Name:TURTZO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S SCHANCK AVE
Mailing Address - Street 2:
Mailing Address - City:PEN ARGYL
Mailing Address - State:PA
Mailing Address - Zip Code:18072-1697
Mailing Address - Country:US
Mailing Address - Phone:610-863-4424
Mailing Address - Fax:610-863-6341
Practice Address - Street 1:101 S SCHANCK AVE
Practice Address - Street 2:
Practice Address - City:PEN ARGYL
Practice Address - State:PA
Practice Address - Zip Code:18072-1697
Practice Address - Country:US
Practice Address - Phone:610-863-4424
Practice Address - Fax:610-863-6341
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO17492L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104068Medicare UPIN
PA790009Medicare UPIN