MEDICARE: DR. DAVID BARRY MCBURNETT D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D9805	TX

General Provider Information

NPI Number	:	1578605531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BARRY MCBURNETT D.D.S.

Provider Business Mailing Address
First Line	:	13701 NORTHWEST BLVD STE C
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78410-5114
Country	:	US
Telephone Number	:	361-387-1507
Fax Number	:	361-387-2470

Provider Business Practice Location Address
First Line	:	13701 NORTHWEST BLVD STE C
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78410-5114
Country	:	US
Telephone Number	:	361-387-1507
Fax Number	:	361-387-2470

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/08/2007

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