Provider Demographics
NPI:1528142544
Name:KELLI A. TURNER, DDS, PC
Entity type:Organization
Organization Name:KELLI A. TURNER, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:ARNET
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-321-2702
Mailing Address - Street 1:1506 CHURCH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-3019
Mailing Address - Country:US
Mailing Address - Phone:615-321-2702
Mailing Address - Fax:615-327-0090
Practice Address - Street 1:1506 CHURCH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-3019
Practice Address - Country:US
Practice Address - Phone:615-321-2702
Practice Address - Fax:615-327-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN53051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3225743Medicaid