MEDICARE: DR. JAMES PAUL BURTON JR.

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	2463	AR

General Provider Information

NPI Number	:	1578655742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PAUL BURTON JR.

Provider Business Mailing Address
First Line	:	6 MARANS DR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72223-9126
Country	:	US
Telephone Number	:	501-868-7106
Fax Number	:

Provider Business Practice Location Address
First Line	:	8116 CANTRELL RD
Second Line	:	C
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-2421
Country	:	US
Telephone Number	:	501-227-5200
Fax Number	:

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

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