MEDICARE: PEGGY BURNS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry	DH18473	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245395078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY BURNS DDS

Provider Business Mailing Address
First Line	:	2421 ALDINE MAIL RTE
Second Line	:	SUITE D
City	:	HOUSTON
State	:	TX
Zip	:	77039-5530
Country	:	US
Telephone Number	:	281-573-5156
Fax Number	:	832-243-6531

Provider Business Practice Location Address
First Line	:	2421 ALDINE MAIL RTE
Second Line	:	SUITE D
City	:	HOUSTON
State	:	TX
Zip	:	77039-5530
Country	:	US
Telephone Number	:	281-573-5156
Fax Number	:	832-243-6531

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	03/03/2017

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