Provider Demographics
NPI:1073690962
Name:BURTON, DANIEL ALLAN (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALLAN
Last Name:BURTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 S HILLSIDE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211
Mailing Address - Country:US
Mailing Address - Phone:316-684-5511
Mailing Address - Fax:316-684-8044
Practice Address - Street 1:219 S HILLSIDE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211
Practice Address - Country:US
Practice Address - Phone:316-684-5511
Practice Address - Fax:316-684-8044
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5483122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS8404OtherBCBS OF KS