Provider Demographics
NPI:1174962955
Name:TURNBOW, JACLYN R (DDS)
Entity type:Individual
Prefix:DR
First Name:JACLYN
Middle Name:R
Last Name:TURNBOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JACLYN
Other - Middle Name:R
Other - Last Name:THOMURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:548 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:64034-8920
Mailing Address - Country:US
Mailing Address - Phone:573-639-0036
Mailing Address - Fax:
Practice Address - Street 1:625 E RUSSELL AVE STE C
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-1273
Practice Address - Country:US
Practice Address - Phone:660-747-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2023-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013042705122300000X
KS610041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist