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General NPI Number Information
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NPI Number | 1295873586
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Entity Type | Individual
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Provider Name | GLENN R BURNS D.D.S., F.A.G.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 208 N COLUMBUS ST
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City | LANCASTER
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State | OH
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Zip | 43130-3005
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Country | US
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Telephone | 740-653-8671
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Fax | 740-653-8815
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Provider Business Mailing Address
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Address Line | 208 NORTH COLUMBUS STREET
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City | LANCASTER
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State | OH
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Zip | 43130
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Country | US
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Telephone | 740-653-8671
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Fax | 740-653-8815
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | OH
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