Provider Demographics
NPI:1366476434
Name:BURNS, KENDALL ROBERT III (DMD)
Entity Type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:ROBERT
Last Name:BURNS
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 W 144TH AVE
Mailing Address - Street 2:A400
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020
Mailing Address - Country:US
Mailing Address - Phone:303-460-8700
Mailing Address - Fax:303-460-1588
Practice Address - Street 1:3800 W 144TH AVE
Practice Address - Street 2:A400
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020
Practice Address - Country:US
Practice Address - Phone:303-460-8700
Practice Address - Fax:303-460-1588
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist