Provider Demographics
NPI:1376613117
Name:TURNER, KIM D (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:D
Last Name:TURNER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 NORTHPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6004
Mailing Address - Country:US
Mailing Address - Phone:207-338-5551
Mailing Address - Fax:207-338-0097
Practice Address - Street 1:189 NORTHPORT AVE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6004
Practice Address - Country:US
Practice Address - Phone:207-338-5551
Practice Address - Fax:207-338-0097
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME33021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice