Healthcare Provider Details

I. General information

NPI: 1821181520
Provider Name (Legal Business Name): JOHN A BURNS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 W WASHINGTON ST
NAPOLEON OH
43545-1203
US

IV. Provider business mailing address

4323 HILL STREET
FT JACKSON SC
29207
US

V. Phone/Fax

Practice location:
  • Phone: 419-966-0877
  • Fax:
Mailing address:
  • Phone: 419-966-0877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16724
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: