Provider Demographics
NPI:1114578770
Name:TURNER, JENNIFER (RDH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 LENNOX AVE
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-4946
Mailing Address - Country:US
Mailing Address - Phone:303-246-2456
Mailing Address - Fax:
Practice Address - Street 1:1845 LENNOX AVE
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-4946
Practice Address - Country:US
Practice Address - Phone:303-246-2456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002023425124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist