Provider Demographics
NPI:1740401694
Name:BURTON, BRIAN J (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:BURTON
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2640 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1900
Mailing Address - Country:US
Mailing Address - Phone:970-243-6455
Mailing Address - Fax:970-243-1541
Practice Address - Street 1:2640 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1900
Practice Address - Country:US
Practice Address - Phone:970-243-6455
Practice Address - Fax:970-243-1541
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO92231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics