Provider Demographics
NPI:1457037780
Name:TURKOVICH, MICHELLE MARIE (RDH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:TURKOVICH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:MARIE
Other - Last Name:WESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:152 KALINA ST
Mailing Address - Street 2:
Mailing Address - City:FORT JOHNSON
Mailing Address - State:LA
Mailing Address - Zip Code:71459-3562
Mailing Address - Country:US
Mailing Address - Phone:301-992-4216
Mailing Address - Fax:
Practice Address - Street 1:152 KALINA ST
Practice Address - Street 2:
Practice Address - City:FORT JOHNSON
Practice Address - State:LA
Practice Address - Zip Code:71459-3562
Practice Address - Country:US
Practice Address - Phone:301-992-4216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7473124Q00000X
TX24933124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist