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NPI Code Detail

MEDICARE: JERRY M BURNS DDS PC

MEDICARE: JERRY M BURNS DDS PC
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
11223G0001XGeneral Practice DentistryD4927AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11487864336OTHERDR. RICHARD HOLLEY
21710380027OTHERDR. TAHANY WHITING-ELAKKAD

General Provider Information

NPI Number : 1881181535
Entity Type Code : Organization
Provider Name (Legal Business Name) : JERRY M BURNS DDS PC
Provider Business Mailing Address
First Line : 13909 W CAMINO DEL SOL STE 102
Second Line :
City : SUN CITY WEST
State : AZ
Zip : 85375-1413
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13909 W CAMINO DEL SOL STE 102
Second Line :
City : SUN CITY WEST
State : AZ
Zip : 85375-1413
Country : US
Telephone Number : 623-584-9844
Fax Number :
Authorized Official
Title or Position : HEAD PROVIDER
Name : JERRY BURNS
Credential : DDS
Telephone Number : 623-584-9844
Provider Enumeration Date : 04/18/2018
Last Update Date : 04/18/2018

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Directions to “JERRY M BURNS DDS PC ” Practice Location

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