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General NPI Number Information
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NPI Number | 1851477731
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Entity Type | Individual
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Provider Name | MARTHA DENISE BURNETT O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 01/11/2013
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Provider Practice Location Address
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Address Line | 7300 WYNDAM DR
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City | SACRAMENTO
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State | CA
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Zip | 95823-3003
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Country | US
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Telephone | 916-525-6421
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Fax |
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Provider Business Mailing Address
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Address Line | 8865 FREEMARK WAY
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City | ELK GROVE
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State | CA
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Zip | 95624-3003
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Country | US
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Telephone | 916-813-2714
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8411T
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License Number State | CA
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