Provider Demographics
NPI:1336268853
Name:TURNER, TRACEY L (DMD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:L
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 1:934 BEAVER GRADE RD.
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108
Mailing Address - Country:US
Mailing Address - Phone:412-264-1888
Mailing Address - Fax:412-264-0869
Practice Address - Street 1:934 BEAVER GRADE RD.
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2716
Practice Address - Country:US
Practice Address - Phone:412-264-1888
Practice Address - Fax:412-264-0869
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028178L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice