Provider Demographics
NPI: | 1558754036 |
---|---|
Name: | CRISTOPHER TURMAN P.C. |
Entity Type: | Organization |
Organization Name: | CRISTOPHER TURMAN P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DDS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CRISTOPHER |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TURMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 701-254-4521 |
Mailing Address - Street 1: | PO BOX 430 |
Mailing Address - Street 2: | |
Mailing Address - City: | LINTON |
Mailing Address - State: | ND |
Mailing Address - Zip Code: | 58552-0430 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 701-254-4521 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 521 BEAVER AVE |
Practice Address - Street 2: | |
Practice Address - City: | WISHEK |
Practice Address - State: | ND |
Practice Address - Zip Code: | 58495-7033 |
Practice Address - Country: | US |
Practice Address - Phone: | 701-452-2115 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-03-09 |
Last Update Date: | 2015-03-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
ND | 1971 | 261QD0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
ND | 41356 | Medicaid |