Provider Demographics
NPI:1689768632
Name:BURNS, ANGELA K (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:K
Last Name:BURNS
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 1:220 VILLAGE SQUARE
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774
Mailing Address - Country:US
Mailing Address - Phone:865-458-4869
Mailing Address - Fax:865-458-4735
Practice Address - Street 1:220 VILLAGE SQUARE
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774
Practice Address - Country:US
Practice Address - Phone:865-458-4869
Practice Address - Fax:865-458-4735
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS72751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice