Provider Demographics
NPI:1124035365
Name:BURNS, JOHN WILLIAM (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:BURNS
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WHITING ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043
Mailing Address - Country:US
Mailing Address - Phone:781-749-6050
Mailing Address - Fax:781-749-2201
Practice Address - Street 1:210 WHITING ST
Practice Address - Street 2:UNIT 1
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043
Practice Address - Country:US
Practice Address - Phone:781-749-6050
Practice Address - Fax:781-749-2201
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA102771223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics