Provider Demographics
NPI:1376631549
Name:TURNER, RUSSELL (DMD,FAGD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:DMD,FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1973 CHANDALAR DR
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1392
Mailing Address - Country:US
Mailing Address - Phone:205-663-6246
Mailing Address - Fax:205-663-0242
Practice Address - Street 1:1973 CHANDALAR DR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1392
Practice Address - Country:US
Practice Address - Phone:205-663-6246
Practice Address - Fax:205-663-0242
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL32831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice