Provider Demographics
NPI:1235241746
Name:BURTON, KENDREA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:KENDREA
Middle Name:M
Last Name:BURTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CRESTWOOD BLVD
Mailing Address - Street 2:STE 211
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2034
Mailing Address - Country:US
Mailing Address - Phone:205-271-6851
Mailing Address - Fax:
Practice Address - Street 1:111 B Y WILLIAMS SR DR
Practice Address - Street 2:
Practice Address - City:MIDFIELD
Practice Address - State:AL
Practice Address - Zip Code:35228-2218
Practice Address - Country:US
Practice Address - Phone:205-923-3172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL53821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice