Provider Demographics
NPI:1215134051
Name:TURNEY, TRAVIS LISLE (DDS)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:LISLE
Last Name:TURNEY
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 1:809 EAST VETERANS MEMORIAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010
Mailing Address - Country:US
Mailing Address - Phone:405-485-9559
Mailing Address - Fax:405-485-9569
Practice Address - Street 1:809 E VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010
Practice Address - Country:US
Practice Address - Phone:405-485-9559
Practice Address - Fax:405-485-9569
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5966122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist