Organization
UNIVERSITY PARK FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ALLEN TURNER DDS (OWNER)
(574) 272-4441
Entity
Organization
Contact information
Practice address
16597 STATE ROAD 23, SOUTH BEND, IN 46635-1461
(574) 272-4441
(574) 968-0689
Mailing address
16597 STATE ROAD 23, SOUTH BEND, IN 46635-1461
(574) 272-4441
(574) 968-0689
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
120092272
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200261730
—
IN
Enumeration date
06/29/2015
Last updated
06/29/2015
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