Provider Demographics
NPI:1356412902
Name:TURNER, JOHN WOOTEN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WOOTEN
Last Name:TURNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1023
Mailing Address - Street 2:
Mailing Address - City:MUNFORD
Mailing Address - State:TN
Mailing Address - Zip Code:38058-1023
Mailing Address - Country:US
Mailing Address - Phone:901-837-6300
Mailing Address - Fax:901-837-6314
Practice Address - Street 1:843 SOUTH TIPTON ROAD
Practice Address - Street 2:SUITE E
Practice Address - City:MUNFORD
Practice Address - State:TN
Practice Address - Zip Code:38058-6303
Practice Address - Country:US
Practice Address - Phone:901-837-6300
Practice Address - Fax:901-837-6314
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN71071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice