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General NPI Number Information
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NPI Number | 1730181181
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Entity Type | Individual
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Provider Name | BONNIE L. BURTON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 1320 NW HOMESTEAD DR SUITE I
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City | LAWTON
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State | OK
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Zip | 73505-5288
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Country | US
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Telephone | 580-536-2662
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Fax | 580-536-2226
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Provider Business Mailing Address
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Address Line | 1320 NW HOMESTEAD DR SUITE I
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City | LAWTON
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State | OK
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Zip | 73505-5288
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Country | US
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Telephone | 580-536-2662
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Fax | 580-536-2226
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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 | 4098
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License Number State | OK
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