Provider Demographics
NPI:1851463806
Name:THOMAS S TURRY PA
Entity Type:Organization
Organization Name:THOMAS S TURRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:TURRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-464-3052
Mailing Address - Street 1:20 LAKE ST N
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-2523
Mailing Address - Country:US
Mailing Address - Phone:651-464-3052
Mailing Address - Fax:651-464-4023
Practice Address - Street 1:20 LAKE ST N
Practice Address - Street 2:SUITE 205
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2523
Practice Address - Country:US
Practice Address - Phone:651-464-3052
Practice Address - Fax:651-464-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN97621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty