Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 22422 | FL |
NPI | 1003252685 |
---|---|
Provider Name | Mark Edward Turner |
First Address | Bronx, NY 10464-1225 |
Second Address | Stuart, FL 34994-9314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2013 |
Last Update Date | 14/11/2017 |