Provider Demographics
NPI:1396009338
Name:GUTHRIE, DAVID BURRELL III (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BURRELL
Last Name:GUTHRIE
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 1:3001 HAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2809
Mailing Address - Country:US
Mailing Address - Phone:408-314-4968
Mailing Address - Fax:
Practice Address - Street 1:910 ENTERPRISE CT UNIT A276
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40510-1034
Practice Address - Country:US
Practice Address - Phone:614-401-4415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL11540122300000X
KY93221223D0004X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No122300000XDental ProvidersDentist
No1223D0004XDental ProvidersDentistDentist Anesthesiologist