Provider Demographics
NPI:1336283019
Name:JON D TURESKY DMD PC
Entity Type:Organization
Organization Name:JON D TURESKY DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:D
Authorized Official - Last Name:TURESKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-762-7077
Mailing Address - Street 1:1 WALPOLE STREET
Mailing Address - Street 2:JON D TURESKY DMD PC
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-762-7077
Mailing Address - Fax:781-762-4398
Practice Address - Street 1:1 WALPOLE STREET
Practice Address - Street 2:JON D TURESKY DMD PC
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-762-7077
Practice Address - Fax:781-762-4398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA144631223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T57267Medicare UPIN