Provider Demographics
NPI:1962942227
Name:TURNER, JOHNIQUE FONVILLE (DMD)
Entity type:Individual
Prefix:
First Name:JOHNIQUE
Middle Name:FONVILLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5529 WEATHERED ROCK CT
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-6640
Mailing Address - Country:US
Mailing Address - Phone:252-876-6865
Mailing Address - Fax:
Practice Address - Street 1:1796 GLIDEWELL DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8245
Practice Address - Country:US
Practice Address - Phone:336-223-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC109021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice