Provider Demographics
NPI:1053794990
Name:TURLA, JUSTINE ANNE
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:ANNE
Last Name:TURLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25180 HUSTON ST
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1672
Mailing Address - Country:US
Mailing Address - Phone:361-460-2077
Mailing Address - Fax:
Practice Address - Street 1:1200 SAVIERS RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-1732
Practice Address - Country:US
Practice Address - Phone:805-248-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105960122300000X
TX310631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice