Healthcare Provider Details
I. General information
NPI: 1740114230
Provider Name (Legal Business Name): ANDREW BURTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 S 4TH AVE STE 120
MORTON IL
61550-3401
US
IV. Provider business mailing address
1600 S 4TH AVE STE 120
MORTON IL
61550-3401
US
V. Phone/Fax
- Phone: 309-733-7700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 019.037111 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: