Healthcare Provider Details

I. General information

NPI: 1063506533
Provider Name (Legal Business Name): HAROLD NEWTON BURTON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1771 INDEPENDENCE COURT SUITE 2
BIRMINGHAM AL
35216
US

IV. Provider business mailing address

1771 INDEPENDENCE COURT SUITE 2
BIRMINGHAM AL
35216
US

V. Phone/Fax

Practice location:
  • Phone: 205-870-5834
  • Fax: 205-870-1618
Mailing address:
  • Phone: 205-870-5834
  • Fax: 205-870-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2842
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: