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General NPI Number Information
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NPI Number | 1285854703
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Entity Type | Individual
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Provider Name | JOHN BURTENSHAW
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Gender | Male
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2295 S CHAMBERS RD #E
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City | AURORA
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State | CO
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Zip | 80014-4544
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Country | US
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Telephone | 303-751-6511
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Fax |
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Provider Business Mailing Address
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Address Line | 1662 WINTERBERRY LN
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City | WESTON
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State | FL
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Zip | 33327-2338
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Country | US
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Telephone | 954-385-3770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8655
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License Number State | CO
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