Provider Demographics
NPI:1316019078
Name:BENNETT L TURNBOW DDS PC
Entity type:Organization
Organization Name:BENNETT L TURNBOW DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNETT L TURNBOW
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TURNBOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:660-747-7512
Mailing Address - Street 1:625 E RUSSELL AVE STE C
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-9605
Mailing Address - Country:US
Mailing Address - Phone:660-747-7512
Mailing Address - Fax:660-747-0271
Practice Address - Street 1:625 E RUSSELL AVE STE C
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-9605
Practice Address - Country:US
Practice Address - Phone:660-747-7512
Practice Address - Fax:660-747-0271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO012752261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental