Healthcare Provider Details

I. General information

NPI: 1033242532
Provider Name (Legal Business Name): PAUL BURTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/23/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 EL MIRAGE ST
PAGE AZ
86040-0590
US

IV. Provider business mailing address

PO BOX 2369
PAGE AZ
86040-2369
US

V. Phone/Fax

Practice location:
  • Phone: 928-660-9220
  • Fax:
Mailing address:
  • Phone: 928-660-9220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS-09828
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD3897
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: