Provider Demographics
NPI:1437191525
Name:BURNS, GAIL DENISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:DENISE
Last Name:BURNS
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 1:128 PENNSYLVANIA AVE E
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2533
Mailing Address - Country:US
Mailing Address - Phone:814-723-4488
Mailing Address - Fax:814-723-0769
Practice Address - Street 1:128 PENNSYLVANIA AVE E
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2533
Practice Address - Country:US
Practice Address - Phone:814-723-4488
Practice Address - Fax:814-723-0769
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 024216 L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics