Provider Demographics
NPI:1275756231
Name:DR. DAVID BURROW DDS PA
Entity Type:Organization
Organization Name:DR. DAVID BURROW DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURROW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-561-1610
Mailing Address - Street 1:304 PRINCESS DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791
Mailing Address - Country:US
Mailing Address - Phone:903-839-8951
Mailing Address - Fax:
Practice Address - Street 1:212 GRANDE BLVD
Practice Address - Street 2:SUITE B210
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-4226
Practice Address - Country:US
Practice Address - Phone:903-561-1610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty