Provider Demographics
NPI:1992734180
Name:TURNER, REESE R (DDS)
Entity type:Individual
Prefix:
First Name:REESE
Middle Name:R
Last Name:TURNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:REESE
Other - Middle Name:R
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6290 W MONONA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6776
Mailing Address - Country:US
Mailing Address - Phone:602-620-1925
Mailing Address - Fax:
Practice Address - Street 1:9059 W LAKE PLEASANT PKWY
Practice Address - Street 2:#A-100
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-8336
Practice Address - Country:US
Practice Address - Phone:623-572-0102
Practice Address - Fax:623-572-0547
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD52161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice