Provider Demographics
NPI:1740295260
Name:JEFFREY G. TURCOTTE DDS PLC
Entity type:Organization
Organization Name:JEFFREY G. TURCOTTE DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:TURCOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-963-0580
Mailing Address - Street 1:131 IROQUOIS AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3324
Mailing Address - Country:US
Mailing Address - Phone:269-963-0580
Mailing Address - Fax:269-963-5379
Practice Address - Street 1:131 IROQUOIS AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3324
Practice Address - Country:US
Practice Address - Phone:269-963-0580
Practice Address - Fax:269-963-5379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12374122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4051554Medicaid
MI$$$$$$$$$OtherSOCIAL SECURITY #
MI1237403OtherBLUE CROSS BLUE SHEILD #