Provider Demographics
NPI:1740381565
Name:TURNER, WILLIAM DOUGLAS (DDS RPH)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DOUGLAS
Last Name:TURNER
Suffix:
Gender:M
Credentials:DDS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N DOUGLASS ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MO
Mailing Address - Zip Code:63863-1509
Mailing Address - Country:US
Mailing Address - Phone:573-276-4506
Mailing Address - Fax:573-276-4507
Practice Address - Street 1:701 N DOUGLASS ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MO
Practice Address - Zip Code:63863-1509
Practice Address - Country:US
Practice Address - Phone:573-276-4506
Practice Address - Fax:573-276-4507
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0133641223G0001X
MO028954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered183500000XPharmacy Service ProvidersPharmacist