Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 63118 | CA |
NPI | 1043640667 |
---|---|
Provider Name | Dr. Deandra Nichelle Turner |
First Address | Cerritos, CA 90703-5541 |
Second Address | Los Angeles, CA 90037-3632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2013 |
Last Update Date | 04/05/2017 |