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General NPI Number Information
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NPI Number | 1851563423
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Entity Type | Organization
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Legal Business Name | F. JEROME BURR, DDS, MDS, PLLC
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 314 E COLLEGE ST
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City | DICKSON
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State | TN
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Zip | 37055-1832
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Country | US
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Telephone | 615-446-6041
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Fax | 615-446-6094
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Provider Business Mailing Address
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Address Line | 1232 CAMP RAVINE RD
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City | BURNS
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State | TN
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Zip | 37029-5259
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Country | US
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Telephone | 615-218-7770
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Fax | 615-446-6094
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. FREDERICK JEROME BURR
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Credential | D.D.S., M.D.S.
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Telephone | 615-390-1002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 8270
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License Number State | TN
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