Provider Demographics
NPI:1114914850
Name:BURGNER, DENNIS L (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:L
Last Name:BURGNER
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 1:10470 S PROGRESS WAY
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4037
Mailing Address - Country:US
Mailing Address - Phone:720-870-9500
Mailing Address - Fax:720-870-9582
Practice Address - Street 1:10470 S PROGRESS WAY
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4027
Practice Address - Country:US
Practice Address - Phone:720-870-9500
Practice Address - Fax:720-870-9582
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
CO1047261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice