Provider Demographics
NPI:1629207758
Name:BURNETT, JANNA ELOISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:ELOISE
Last Name:BURNETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 E HEBRON PKWY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3012 E HEBRON PKWY
Practice Address - Street 2:SUITE 108
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4464
Practice Address - Country:US
Practice Address - Phone:972-662-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist