Provider Demographics
NPI:1528133386
Name:TORKORNOO, PERCY LESLIE (DDS)
Entity type:Individual
Prefix:DR
First Name:PERCY
Middle Name:LESLIE
Last Name:TORKORNOO
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 1:3989 COLONEL GLENN HWY STE A
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45324-2099
Mailing Address - Country:US
Mailing Address - Phone:937-426-2400
Mailing Address - Fax:937-426-2400
Practice Address - Street 1:3989 COLONEL GLENN HWY STE A
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45324-2099
Practice Address - Country:US
Practice Address - Phone:937-426-2400
Practice Address - Fax:937-426-1144
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0023658122300000X
KS602431223G0001X
OH30022493122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice