Provider Demographics
NPI:1073529004
Name:TURKIEWICZ, TOMMY (DMD)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:TURKIEWICZ
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 1:101 PARK PL
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1273
Mailing Address - Country:US
Mailing Address - Phone:770-486-1218
Mailing Address - Fax:770-486-5704
Practice Address - Street 1:101 PARK PL
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1273
Practice Address - Country:US
Practice Address - Phone:770-486-1218
Practice Address - Fax:770-486-5704
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice